Specialty Pharmacy Technician Liaison

Corewell Health • Grand Rapids, MI

2d • Hybrid

About The Position

About the Medication Care Coordination Team The Medication Care Coordination Team (MCC) is a centralized team that works closely with Specialty Clinics across all Corewell Health regions to help obtain prior authorizations (PA’s) for high-cost medications, quantity limits, tier exceptions, and non-formulary medications that are ordered by providers. The MCC team covers multiple provider offices and specialties and collaborates with insurance companies, pharmacies, and Corewell Health clinics to obtain the necessary information for completing a prior authorization and ensuring accurate prescription processing at the destination pharmacy. Specialty Pharmacy Scope of Work Coordinates prior authorization and prescription processing in collaboration with the Corewell Health Specialty Pharmacy (CHSP) staff for specialty medications prescribed for patients of select Corewell Health clinics. Additionally, these liaisons support prior authorization and specialty prescription coordination for specialty medications that are filled at any external specialty pharmacy when prescribed from the covered clinics. Works in collaboration with clinic and pharmacy staff to facilitate patient access to specialty medications and drive utilization of internal specialty pharmacy services. Performs insurance benefit investigations and prior authorizations to facilitate appropriate access to specialty medications. Coordinates financial assistance through manufacturer and third-party programs to ensure patient affordability. Resolves various adjudication errors and rejections. Communicates directly with prescribing clinic/office staff, patients, and insurance companies to arrange timely approval, fulfillment, and delivery of medications. Provides exceptional customer service through telephone and/or in-person communications. This position may be based within a clinic or in the specialty pharmacy depending upon need. Pulls, transcribes, and organizes clinical information from patient charts into third party platforms or navigators. Performs all necessary aspects of the medication prior authorization process, including obtaining required medical information, completing paperwork or electronic submission of prior authorization forms, and communicating with third party payers as necessary to obtain approval and prevent therapy interruptions. Performs prescription data entry, adjudicates claims, and resolves third party exceptions. Identifies patients eligible for financial assistance through manufacturer-provided or third-party sponsored program. Facilitates patient enrollment in programs to reduce out-of-pocket expense. Documents activities in the appropriate system(s) to provide a record of care and facilitate handoff among various team members. Provides exceptional customer service to patients, provider office staff, and all outside business associates. Develops collaborative working relationships with providers, clinics, and office-staff. Provides education to patients and clinic staff on the benefits and services provided by the Specialty Pharmacy. Facilitates patient enrollment in the Specialty Pharmacy Patient Management Program. Responsible for data collection and/or reporting related to assigned area/projects as needed. Serves as a role model and leader in the department. Escalates any concerns that are identified in their area of work through chain of command. Participates in training pharmacy team members.

Requirements

• High School Diploma or equivalent
• 2 years of relevant experience in Pharmacy
• Retail or specialty pharmacy experience
• LIC-Pharmacy Technician - STATE_MI State of Michigan Upon Hire required
• CRT-Pharmacy Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board 90 Days required

Nice To Haves

• Ideal candidate will be a Pharmacy Technician possessing Full Michigan Pharmacy Technician License and National Pharmacy Technician Certification, such as PTCB or ExCPT
• Ideal candidate will also possess either Specialty Pharmacy, Prior Authorization experience or Retail Pharmacy experience

Responsibilities

• Coordinates prior authorization and prescription processing in collaboration with the Corewell Health Specialty Pharmacy (CHSP) staff for specialty medications prescribed for patients of select Corewell Health clinics.
• Supports prior authorization and specialty prescription coordination for specialty medications that are filled at any external specialty pharmacy when prescribed from the covered clinics.
• Works in collaboration with clinic and pharmacy staff to facilitate patient access to specialty medications and drive utilization of internal specialty pharmacy services.
• Performs insurance benefit investigations and prior authorizations to facilitate appropriate access to specialty medications.
• Coordinates financial assistance through manufacturer and third-party programs to ensure patient affordability.
• Resolves various adjudication errors and rejections.
• Communicates directly with prescribing clinic/office staff, patients, and insurance companies to arrange timely approval, fulfillment, and delivery of medications.
• Provides exceptional customer service through telephone and/or in-person communications.
• Pulls, transcribes, and organizes clinical information from patient charts into third party platforms or navigators.
• Performs all necessary aspects of the medication prior authorization process, including obtaining required medical information, completing paperwork or electronic submission of prior authorization forms, and communicating with third party payers as necessary to obtain approval and prevent therapy interruptions.
• Performs prescription data entry, adjudicates claims, and resolves third party exceptions.
• Identifies patients eligible for financial assistance through manufacturer-provided or third-party sponsored program.
• Facilitates patient enrollment in programs to reduce out-of-pocket expense.
• Documents activities in the appropriate system(s) to provide a record of care and facilitate handoff among various team members.
• Develops collaborative working relationships with providers, clinics, and office-staff.
• Provides education to patients and clinic staff on the benefits and services provided by the Specialty Pharmacy.
• Facilitates patient enrollment in the Specialty Pharmacy Patient Management Program.
• Responsible for data collection and/or reporting related to assigned area/projects as needed.
• Serves as a role model and leader in the department.
• Escalates any concerns that are identified in their area of work through chain of command.
• Participates in training pharmacy team members.

Benefits

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance, pet insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED