SPECIALTY PHARMACY PROGRAM OPERATIONS SPECIALIST (100% FTE, ROTATING/VARIABLE SHIFTS)

About the position

The UW MEDICAL CENTER - MONTLAKE - PHARMACY DEPARTMENT is looking for an outstanding SPECIALTY PHARMACY PROGRAM OPERATIONS SPECIALIST to join our Pharmacy team! This position is responsible for the direction and control of the UWMC Specialty Pharmacy program for assigned clinics, maximizing pharmacy reimbursement through programs that provide funding or provision of medication, and overseeing the Medication Assistance Program (MAP) for specialty medications. The role includes providing MAP information and education to providers, patients, and pharmacy and other medical center personnel.

Responsibilities

• Maintain current knowledge of all aspects of industry sponsored medication assistance programs and provide routine training, support and feedback to Specialty Pharmacy Program Operations Specialists.
• Determine patient eligibility for the MAP and work collaboratively with Patient Financial Services, Social Work and other medical center personnel to ensure clinical and financial documentation is complete for program enrollment.
• Obtain necessary information from patient and provider to enable justification for Medication Assistance program for initial start and renewal of specialty medications.
• Manage the application process, eligibility verification, current drug list and current application forms for patients eligible for the MAP.
• Participate in the Specialty Committee and develop a plan to improve, streamline, and increase the efficiency and effectiveness of the specialty pharmacy program.
• Function as patient advocate to acquire medication for financially disadvantaged patients.
• Serve as a subject matter expert for physicians, administrators, clinical staff, pharmacy staff, and third party payers regarding industry sponsored specialty medication assistance programs.
• Provide education of Specialty Pharmacy and MAP to pharmacy, clinics, social workers and physicians.
• Assist in developing marketing materials for patients and clinic staff.
• Make presentations to clinic staff describing services provided including education about medication assistance programs and medication reimbursement issues with specialty pharmaceuticals.

Requirements

• Current certification as a Pharmacy Technician in Washington State.
• Bachelor's degree in health care related or business field or 2-3 years experience as a pharmacy technician.
• Knowledge of third-party insurance billing practices, federal and state regulations with regard to billing and reimbursement, internal billing structure and pharmacy billing procedures.