Specialty Pharmacy Liaison
All the benefits and perks you need for you and your family:
Commitment to whole-person care, giving you the opportunity to help heal people in mind body and spirit.
Excellent benefits, market-driven wages and career development opportunities.
Opportunities for advancement as we expand our network across the nation.
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Hours vary Mon-Fri 8am-8pm, Saturday and Sunday 9am-6pm
Shift : Full Time
Location: Orlando, FL
The role you’ll contribute:
The Specialty Pharmacy Liaison will be responsible for but not limited to the following: will be required to work closely with AdventHealth specialty clinical teams and other specialty disease states departments to improve patient outcome, by assisting with processing, filling and delivery of their medications. Leads and has primary responsibility with receiving referrals, verifying patient demographics and medication coverage in the database, initiating, and obtaining prior authorization requests, facilitate patient assistance, appeals, peer reviews, and co-pay assistance. Ensure communication with specialty patients and the referral source. Serves as specialist for outpatient pharmacies with prescriptions requiring prior authorization, patient assistance, appeals and co-pay assistance. Develop content and present to providers offices regarding clinical services and provides pertinent metrics related to their prior authorization and patient funding success rates. Complete all daily, weekly, and monthly required documentation required for data collection and analysis. The Specialty Pharmacy Liaison will serve as the main point of contact to facilitate communication between the Pharmacy and all specialty departments. Performs other duties as necessary for the effective daily operations of the outpatient pharmacy and assist in a range of supportive duties consistent with the goals, policies, and procedures of the pharmacy. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
The value you’ll bring to the team:
Demonstrates, through behavior, AdventHealth’s Core Values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork Prior Authorizations and Appeals Gather all pertinent information from the EMR to navigate complex PA process. Provide communication, PA, and appeal support to AdventHealth Outpatient Pharmacies. Seek additional chart notes and documentation required for peer review process in the event of a PA denial.Maintain clinical knowledge of specialty disease states andcovered indications for specialty and non-specialty medications to facilitate successful PA approvalMaintains accurate and up to date documentation and communicates with providers’ offices and members within stated service level expectations, providing updates at specific intervals or as needed Prescription processing specialist :
Follow a systematic procedure for assisting with the flow of prescriptions through the outpatient pharmacy. Upon receipt of referrals, verify accuracy of patient information, verify insurance information and initiate prior authorization request when required.
Promptly communicate all unresolved third-party rejection and prior authorization request issues to the referral source and the patient, and document such events as required. Maintain current patient information in pharmacy management system. Assure that patient has signed HIPAA release.
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.