Specialty Pharmacy Care Coordinator II (Oncology) Louisville Area

Duties and Responsibilities:

• Completes benefit investigations to verify patient eligibility for prescribed specialty medications.
• 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.
• 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.
• Commits to sustained compliance with accreditation standards through completion of required activities, ongoing training, and survey preparation and participation as needed.

Qualifications:

• High school diploma or equivalent is required.
• Current Kentucky Board of Pharmacy technician registration.
• National Pharmacy Technician Certification required.
• Pharmacy technician experience required.
• Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
• Prior experience with Epic EMR preferred.