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 the ambulatory clinic team by facilitating patient access to complex specialty medication therapies. They collaborate with insurers, nursing, social workers, and pharmacy staff to obtain authorizations, investigate benefits, and locate copay assistance, while escalating clinical questions to pharmacists and tracking outcomes to improve patient care.
Key focus areas include Complete benefit investigations to verify patient eligibility for prescribed specialty medications., Maintain current knowledge of payer formularies and reimbursement., and Support third‑party prior authorization process and obtain appropriate overrides..
Important skills include Benefits Investigations, Payer Formularies Knowledge, Reimbursement Knowledge, Pharmacy Trends, Third Party Prior Authorization Process, and Accurate Insurance Information Maintenance.
Skills & qualifications
Skills
Qualifications
Full job description
Experience Required
None
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 2800 Breckenridge Lane, Louisville, KY!
Completes benefit investigations to verify patient eligibility for prescribed specialty medications.
Maintains current knowledge of payer formularies and reimbursement.
Engages in personal development to stay updated with pharmacy trends related to role and practice setting.
Supports third party prior authorization process and obtain appropriate overrides to improve speed to therapy for new patients.
Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy
Triages patient or caregiver clinical questions, medication related concerns, and third-party insurance denials to the pharmacist for intervention as appropriate.
Utilizes Electronic Health Record to maintain communication between departments and ensure accurate documentation of patient care activities.
Communicates and represents pharmacy effectively throughout all levels of the organization.
Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers.
Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support, communicate changes in medication related coverage and regulatory mandates.
Facilitates enrollment of patients in patient assistance programs to maximize copay savings and assist with gathering appropriate documentation.
Utilizes technology to organize daily outreach tasks to complete prescription refills, delivery coordination, and claim processing on time.
Minimum Qualifications
High school diploma or equivalent.
Registration with Kentucky Board of Pharmacy upon hire date.
Pharmacy technician experience required.
Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
Prior experience with Epic electronic medical record preferred.
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
R26104575
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