Patient Care Coord- Specialty Pharmacy

About the role

Number of Positions In Requisition

1

Job Details

Specialty Pharmacy Patient Care Navigators handle a broad variety of interactions with clients, providers, payers and manufacturers critical to the services provided by the Specialty Pharmacy. The core functions include handling incoming and outgoing client and patient interactions and follow thru and resolution of customer inquiries. Interactions include calls from patients, families, provider offices, payers, and manufacturers.

Handles other miscellaneous tasks, including the reconciliation of delivery tickets, and investigating expired prescriptions and encounters. Handle every interaction with the utmost service and resolve; providing a patient/client experience that supports our commitment to efficient and effective connections to care.

Interact with a diverse patient base to ascertain the reason for the interaction and assist the client with their inquiry, concerns or problems with a focus on first call resolution. Demonstrate commitment to service and follow-through. Follow departmental protocols to ensure patient safety and accurate data entry.

About the role

Our Specialty Pharmacy location: 3500 Horizon Dr, King of Prussia, PA 19406

Job Duties

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.(Do not delete, move or over-write this statement)
• Receive, Handle, and Triage calls/interactions accordingly based on client's needs including but not limited to: Assessing refill needs, scheduling delivery of medications, copay collections, package & delivery tracking, obtaining payer/copay card information, status updates of orders, receiving/relaying information to the client
• Practice First Call Resolution by identifying and assessing client needs to work towards a satisfactory solution
• Assess for clinical escalation to pharmacist where appropriate
• Accurately research and document all interactions within the Electronic Medical Record (EMR) per departmental policy and guidance
• Access EMR and other software to answer, coordinate, track, and monitor interactions across multiple channels of communication. Maintain qualitative and quantitative individual and team performance targets.
• Identify issues and communicate solutions to customers, pharmacies, physicians, and payers regarding scheduling and delivery information, prescription order status, eligibility, and claims information
• Effectively collaborate with internal departments and external entities to resolve customer issues, including billing, logistics, insurance coverage, and manufacturer copay card programs
• Additional administrative and pharmacy tasks and duties may be assigned by management

Minimum Qualifications

• 3 years experience in customer service role and
• 1 year experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment.
• Maintain knowledge of and comply with regulatory guidelines set forth by the State Board of Pharmacy, FDA, DEA, DHS, Medicare, TJC, and URAC as applicable to functional role
• Demonstrated ability to listen skillfully, accurately collect & document relevant information, and build relationships and trust with
• Knowledge of and ability to utilize practices, tools, and techniques for communicating with a client
• Knowledge of the major responsibilities, accountabilities, and overall organization of the client support function or department, ability to properly support client inquiries and bring problems to a timely resolution.
• Independently resolves complex client conflicts including but not limited to: damaged/lost products, order placement, and outstanding balances and invoices
• Multi-task between several issues at one time

Preferred Qualifications

• High School Diploma/GED

Additional Qualifications

• Proficient in the use of computers and Microsoft applications. Type 35 wpm.
• Experience with clinical software systems; Specialty Medications and Medicare billing is highly preferred.
• Ability to communicate professionally and efficiently in both written and verbal format with patients, physicians, payors and clinical staff in-person and on the phone.
• Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc.
• Detailed orientated with excellent organization skills, ability to learn quickly, solve problems and make informed educated decisions.
• Ability to adapt in a dynamic work environment
• Demonstrated ability to handle difficult conversations in a professional and caring manner

Physical Demands

Lift and carry 40-50 lbs. Examples: Push/pull patients on bed, stretcher (requires 29 lbs. push force), lateral transfers up to 50 lbs. of the patient's weight. Frequent to continuous standing/walking. Patient transporters can walk 8-10 miles per shift. *Patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.

Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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