Specialty Pharmacy Care Coordinator - Oncology

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.