Specialty Pharmacy Program Operations Specialist

University of Washington Medical Center • Seattle, WA

1d

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! WORK SCHEDULE · Full-Time / 40 hours per week · Rotating/Variable Shift POSITION HIGHLIGHTS · Be responsible for the direction and control of the UWMC Specialty Pharmacy program for assigned clinics · Maximize pharmacy reimbursement through programs that provide funding or provision of medication · Be responsible for direction and control of the Medication Assistance Program (MAP) for specialty medications, including development of processes and procedures · Provide MAP information and education to providers, patients and pharmacy and other medical center personnel

Requirements

• Current certification as a Pharmacy Technician in Washington State.
• Bachelors 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.
• LEGAL REQUIREMENT State of Washington Pharmacy Technician certification
• CONDITION OF EMPLOYMENT UW Medicine is committed to being a drug-free workplace. We require a pre-employment drug screen.

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, whose job functions include referral for medication assistance.
• 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.
• For patients who are eligible for the MAP: manage the application process, eligibility verification, current drug list and current application forms. Maintain all required patient documentation as required by individual programs.
• Participate in the Specialty Committee. Develop a plan to improve, streamline, and increase the efficiency and effectiveness of the specialty pharmacy program. Work with the Specialty Pharmacy team to evaluate and further develop systems and processes including: developing a process for tracking prior authorizations and appeals, evaluating Medication Assistance Program software for documentation and tracking applications, renewals and patient communication including developing an ROI, budget proposal and implementation plan.
• Function as patient advocate in order to acquire medication for financially disadvantaged patients.
• Serve as a subject matter expert for physicians, administrators, clinical staff, pharmacy staff, and third party payers for issues 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. Develop materials explaining mail order services including enrollment forms for patients. Make presentations to clinic staff describing services provided including education about medication assistance programs and medication reimbursement issues with specialty pharmaceuticals.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees