Specialty Pharmacy Care Coordinator
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At a glance
Requirements
Credentials this posting asks for.
Job overview
Baptist Health is hiring a Specialty Pharmacy Care Coordinator. The Pharmacy Care Coordinator supports patient access to complex medication therapies by collaborating with insurance companies, nursing, social workers, and pharmacy to obtain appropriate authorization for medications. This role involves tasks related to prescription billing, including benefits investigations, prior authorization assistance, and identifying copay assistance options. The coordinator also escalates clinical support needs to pharmacists and coordinates patient outreach to ensure continuity of care.
Key focus areas include Complete benefit investigations to verify patient eligibility for prescribed specialty medications, Assess requirements for authorization of medications and maintain knowledge of payer formularies and reimbursement, and Support third party prior authorization process and obtain appropriate overrides for new patients.
Successful candidates bring High School Diploma/G.E.D., 2-20 Years Experience, and Kentucky Pharmacy Technician Registration. Important skills include Microsoft Word. Preferred (not required): Benefit Investigations, Payer Formularies Knowledge, Reimbursement Knowledge, and Prior Authorization Process.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
Experience Required
2 - 20 years
Minimum Education Required
High School Diploma/G.E.D.
Compensation
$7.25 / hourly
Hours Per Week
40
Number Of Positions
1
Work Schedule and Shift Requirements
First (Day)
Job Description
Summary
The Pharmacy Care Coordinator acts as an extension of the ambulatory clinic team to support patient access to high touch, complex medication therapies. Works in collaboration with insurance companies, nursing, social workers, and pharmacy to obtain appropriate authorization for medications including
registration with drug specific manufacturer programs when applicable. Performs tasks related to prescription billing including completing benefits investigations, assisting with the prior authorization process, and locating copay assistance options for patients to ensure affordability of specialty medications.
The Pharmacy Care Coordinator escalates clinical support needs and questions to the pharmacist. Assists with clinic intervention outcomes tracking to monitor value of services. Coordinates patient outreach during clinic visits or via telephonic follow up to ensure continuity of care and optimize patient outcomes. Responsibilities may include working to establish and maintain short- and long-term quality improvement goals.
Job Description:
Baptist Health is searching for a Specialty Pharmacy Care Coordinator to join our team at the Central Pharmacy, LaGrange, KY!
Completes benefit investigations to verify patient eligibility for prescribed specialty medications.
Assesses requirements for authorization of medications and maintain knowledge of payer formularies and reimbursement.
Supports third party prior authorization process and obtain appropriate overrides for new patients.
Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy.
Identifies financial assistance options to maximize copay savings and increase therapy adherence.
Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support and communicate changes in medication-related coverage.
Utilizes the Electronic Health Record (HER) to maintain communication between departments and ensure accurate documentation in patient electronic charts.
Performs phone functions professionally and in a timely manner, including answering phones, returning calls, and checking voice mail.
Coordinates patient scheduling for initial and follow-up appointments.
Triages patient clinical questions and third-party insurance denials to the pharmacist for intervention as appropriate.
Facilitates adherence to medications by coordinating face-to-face or telephonic patient outreach for timely refills.
Maintains a record of activities to support data collection, analysis, and ongoing reporting to leadership related to patient metrics and financial performance.
Acts as a contact person for all non-clinical patient/customer questions.
Minimum Qualifications
High school diploma or equivalent.
Current or eligible for Kentucky pharmacy technician registration (if not already registered with KY Board of Pharmacy, registration requires only an application and fee).
National Pharmacy Technician Certification preferred.
2+ years pharmacy technician experience preferred.
Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
Prior experience with Epic EMR preferred.
Intermediate knowledge of computer systems and software, including Microsoft Excel and Microsoft Word preferred.
Demonstrated ability to collaborate with healthcare providers and patients to communicate effectively as a patient advocate preferred.
Benefits
Tuition Assistance reimbursement program
Paid Time Off available for use upon hire
Company paid Maternity and Paternity Leave
Bereavement Leave (includes pets)
Employee Assistance Program
Retirement plans with company match
Company paid Basic Life Insurance & Long-Term Disability
Health Insurance, Pharmacy, Dental, Vision and much more!
Work Experience
Education
If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!
Baptist Health is an Equal Employment Opportunity employer.
"EEO Statement: Baptist Health is an Equal Employment Opportunity employer, and seeks to employ individuals without regard to r ace, color, national origin, gender, s exual orientation, gender identity, age, disability, marital status, citizenship status, military status, religious or political beliefs, protected veteran status, employment status or any other protected class identified in any federal, state, or local law. Baptist Health specifically encourages minority, female, disabled, veteran and other candidates from diverse backgrounds to apply and strengthen our team. Please note that Baptist Health is a drug-free workplace and employment with Baptist Health is subject to post offer, pre-employment drug testing.
NOTICE OF NONDISCRIMATION AND ACCESSIBILITY TO SERVICES
Persons with hearing and speech impairments can contact Baptist Health facilities by using the Kentucky Relay Service, a toll-free telecommunication device for the deaf (TDD). For voice to TDD, call 800.648.6057. For TDD to voice, call 800.648.6056."
Job Type
Full time
Benefits Offered
Not specified
Veteran Preference
No
Place of Work
On-site
Requisition ID
R24072662
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