Specialty Pharmacy Care Coordinator - Rheumatology

Pharmacy Care Coordinator

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.

Duties and Responsibilities:

• Completes benefit investigations to verify patient eligibility for prescribed specialty medications.

• Assesses requirements for authorization of medications most commonly prescribed and maintain current knowledge of payer formularies and reimbursement.

• Supports third party prior authorization process and obtains appropriate overrides to improve speed to therapy.

• Maintains accurate insurance information and monitors 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 support.

• Utilizes Electronic Health Record (EHR) 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, checking voice mail, and faxing.

• 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.

Qualifications:

• High school diploma or equivalent is required.

• 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 Office preferred.

Benefits:

• Tuition Reimbursement program up to $6,000 annually

• 40 hours of 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!

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.