Specialty Pharmacy Care Coordinator II - Rheumatology

Summary

The Specialty Pharmacy Care Coordinator acts as an extension of the ambulatory clinic teams to support patient access to high touch, complex medication therapies. This position is based in a specialty pharmacy clinic setting under pharmacist supervision. The Specialty Pharmacy Care Coordinator functions in a multiskilled environment which requires the application of teamwork, leadership and flexibility. Works in collaboration with insurance companies, nursing, and social workers 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. Assists with clinic intervention outcomes tracking to monitor value of services. Coordinates patient outreach for new and enrolled patients to ensure continuity of care and optimize patient outcomes.

Job Description:

Baptist Health is searching for a full-time Specialty Pharmacy Care Coordinator II to join our Rheumatology team at330 Waller Avenue, Lexington, 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.

• Triages patient or caregiver clinical questions, medication related concerns, and third-party insurance denials to the pharmacist for intervention as appropriate.

• 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.

• Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers.

• Utilizes Electronic Health Record to maintain communication between departments and ensure accurate documentation of patient care activities.

• Facilitates enrollment of patients in patient assistance programs to maximize copay savings and assist with gathering appropriate documentation.

• 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.

• 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.

• Kentucky pharmacy technician registration (if not already registered with KY Board of Pharmacy, registration requires only an application and fee).

• National Pharmacy Technician Certification required.

• Pharmacy technician experience preferred.

• Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.

• Prior experience with Epic EMR preferred.

• Must obtain 340B University or Apexus within 6 months.

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.