Specialty Pharmacy Patient Advocate

Job description

Primary City/State: Scottsdale, Arizona Department Name: BFP-Scottsdale Health Center Work Shift: Day Job Category: Pharmacy Pharmacy careers are better at Banner Health. We are committed to developing the careers of our team members. We care about you, your career today and your future. If you’re looking to leverage your abilities – apply today. We are hiring a Specialty Pharmacy Patient Advocate, at our Scottsdale Health Center location (18250 N Hayden Rd, Suite 103.) In this role you will be responsible for completing prior authorizations and communicating outcomes with providers and patients. You are also responsible for helping obtain financial assistance for patients in the form of copay cards, grants, and free drug applications. You will work closely with providers and third parties to reduce the cost hurdles associated with specialty medications. This is a full time position with hours of Monday - Friday, 8AM - 5PM. Banner Pharmacy Services is a recognized leader in healthcare and trusted partner in proactively providing innovative pharmacy services through excellence in integration, care coordination, medication management and services to make a difference in people's lives. Clinical Pharmacy Services is responsible for the management of the Banner formulary, development of standardized system wide clinical pharmacy services, and management of adverse drug event preventions. Clinical Pharmacy Services provides collaborative drug therapy management and educational interventions in patient care to optimize medication therapy, improve outcomes, promote wellness, and disease prevention. As a division, Banner Pharmacy services provides excellent patient care across our entire continuum through convenient access, improved medication outcomes and innovative pharmacy practices. POSITION SUMMARY This position will determine, support and assist patients, provider teams, and the pharmacy department to overcome barriers to medication access, with focused expertise in third-party prior authorization and billing processes for pharmacy benefits. Assist patients with enrollment into grants, assistance programs, and communicate any financial responsibilities. Provide a face-to-face bedside-oriented service that delivers comprehensive fiscal options to patients and provide medication cost after transplant. Gather and effectively communicate medical and medication histories including diagnosis, test results, lab values, and appropriate step therapy to third-party for initial insurance approval. Verify eligibility, benefit provisions, and support the appeals process. CORE FUNCTIONS 1. Coordinate with stakeholders to remove medication access barriers. 2. Maintain current knowledge of pharmacy regulations, payer agreements and assistance programs. 3. Provide timely medication benefit counseling to patients and hospital staff. 4. Accurate and timely execution of pharmacy projects as required. 5. Follow policies, procedures and regulatory requirements and perform other work assignments. MINIMUM QUALIFICATIONS Licensed and registered pharmacy technician in the state of practice, where applicable. Incumbents in Arizona are also required to provide the AZ Board of Pharmacy Wallet Card at time of hire. Minimum of three years of healthcare and/or insurance/third party reimbursement experience required to include one year of technician experience required. Strong customer service focus, superior problem-solving abilities required. Proficiency in Microsoft Word, Excel, network, web-based and payer applications required. Ability to anticipate customer requirements and meet those needs in an appropriate and timely manner is required. Ability to prioritize organization requirements and track progress of multiple initiatives. PREFERRED QUALIFICATIONS Completion of a Pharmacy Technician Certification Program. Associate’s or bachelor’s degree in business, healthcare or related field preferred. Prior authorization experience in specialty or retail pharmacy preferred. Knowledge of commercial, Medicare B, Medicare D and Medicaid pharmacy rules and regulations preferred. Knowledge and experience utilizing McKesson Enterprise, Cerner and Therigy preferred Bi-lingual preferred Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy