Pharmacy Technician/ Prior Authorization Specialist (PrimeRx experience preferred)

About us
**Job Summary:**

We are seeking a dedicated Prescription Navigator to join our healthcare team. Squad Health offers navigation services and software to patients of medical practices to remove barriers to treatment, particularly prescription access. Navigation services include benefits investigation, prior authorization submission, patient assistance enrollment, pharmacy coordination, and patient engagement. Patient navigators will act as extensions of the providers we partner with, operating under general supervision of clinical staff.

**Duties:**

Verify benefits of patient’s insurance for review of drug and procedure orders

Obtain the appropriate authorization for services by completing authorization forms, while working with providers and their staff on unknown clinical questions:

• Fill out clinical questions, including related diagnoses, based on medical notes and documentation
• Fill out prescription questions based on prescription order and medication guidelines
• Check status of pending authorizations and continue to work these.
• STAT orders will require immediate, urgent attention.
• Communicate with MD and NP’s if orders need to be changed on treatment plan or to discuss denials and request letter of medical necessity to appeal authorization denials

Obtain patient assistance support when out of pocket is unaffordable and identify that cost from the pharmacy.

Speak with patients via phone and help navigate barriers to medication treatment plans:

• Enroll patients into navigation program and obtain consent
• Refer patients into social programs that address medication-related needs e.g. transportation assistance, Medicaid enrollment, prescription assistance programs
• Support with patient education and emotional support

Track time spent navigating patients, claims generated and assist with all reporting needs

Document all steps taken in research/process of the case entering information into the team database

Participate in team meetings to problem solve patient issues, and improve company operations on behalf of patients and partner practices

**Skills:**

• 2 years specialty medication authorization experience required
• Pharmacy technician preferred
• Strong patient empathy and communication skills with patients, providers, insurances, pharmacies and other
• Strong persistence and problem-solving skills; must be able to advocate for patient
• High-school/GED required
• Speak english fluently

This position offers the opportunity to make a meaningful impact on patients' lives while working in a collaborative healthcare environment. If you possess the required skills and are passionate about patient advocacy, we encourage you to apply for this rewarding role.

Job Type: Full-time

Pay: Up to $25.00 per hour

Application Question(s):

• Do you have other school or professional commitments during the week?
• Please list 5 medications for which you have frequently completed prior authorizations and can discuss during an interview.
• Have you worked in a hospital or doctor's office completing medication prior authorizations? If so, please elaborate what platforms you have used to submit these.
• Why are you looking to leave (or have already left) your previous employer?
• What are your expected working hours (e.g., 9 - 5pm ET)?

License/Certification:

• Pharmacy Technician Certification (Required)

Work Location: Remote