Scope of Responsibilities: Provide guidance, assistance and expertise regarding specialty assistance programs between ProAct and contract pharmacies to include Noble Health Services and other specialty and/or retail pharmacies. Coordinate with all appropriate parties to secure funding assistance, medication shipment and regularly communicate updates on member-specific cases. Works under direct supervision and follows standard procedures to accomplish assigned tasks.
Job Summary: Responsible for coordinating functions related to specialty assistance programs to include, but not limited to ProActPLUS and other external copay sourcing program related operations on a day-to-day basis. Act as the liaison between ProAct, and Noble Health Services (or other network pharmacies) to support these programs and its components.
ResponsibilitiesJob Duties:
Support ProAct clients and members regarding functions related to specialty assistance programs.Partner with Noble Health Services and other network pharmacies on the administration of ProAct-owned programs such as ProActPLUS as well as third party solutions and other utilization management programs.Perform outreach to physician offices and members to request prescriptions, confirm assistance components, etc.Process overrides in ProAct’s processing database to ensure claims are processing as intended after funding is secured.Assist Noble and other network pharmacies with various other ProAct-related inquiries or overrides that need to be entered for successful claim processing.Complete all mandatory KPH, state, and federal training programs.Perform other duties as assigned. Qualifications Experience Preferred:Preferred: 2 Years experience with Health Care, Insurance and/or Project Management
Special Conditions of Employment:
Drug testInitial and continuous exclusion and sanction/disciplinary monitoringAny and all additional eligibility requirements based on the specific position
Required Training:
HIPPA Privacy Course and CE Mastery ExamHIPPA Security Course and CE Mastery Exam
Job Requirements:
Successful completion of a pre-employment and/or random drug screening test
Job Skills Required:
Strong Communication Skills, must be able to effectively communicate both on the phone and in email setting Strong PC Skills, will be using multiple different PC programsMust be able to work independently
Behavioral Traits Required:
Customer Service: Must provide timely and accurate responses to all business associates and customersOrganization: Must organize work in a systematic way, establish clear lines of responsibility, and delegate effectivelyCommunication: Must write and speak clearly and effectively at all levels, listen and be attentive to othersTechnology: Must use technology to its fullest potential to achieve department and corporate goalsFlexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure Options Apply for this job onlineApplyShareEmail this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Connect With Us! Not ready to apply? Connect with us for general consideration. Application FAQsSoftware Powered by iCIMS
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