pharmacy care coordinator

KabaFusion

<p>JOB SUMMARY:<br/></p><p>Responsible for the coordination of infusion services which include, but are not limited, to scheduling and coordinating patient deliveries, material management, hazardous waste management, facility maintenance, and equipment management. Receives and responds to patient inquiries regarding services rendered, supports efficient billing practices, and may collect payments as needed. Performs designated tasks regarding pharmacy quality control and management of pharmacy records.<br/></p><p>MAJOR DUTIES AND RESPONSIBILITIES:<br/></p><p>Adheres to organization policies and procedures.<br/>Coordinates and schedules deliveries, entering patient lab results and medication profiles, including follow up on any additional required or outstanding documentation.<br/>Faxes lab results, prescriber orders for signature, and other communications to prescribers.<br/>Monitors and assigns incoming faxes.<br/>Maintains patient records, including filing and scanning.<br/>Works in collaboration with assigned pharmacist to organize workload to facilitate its accomplishment.<br/>Performs pre-delivery phone calls to patients, nursing or other agencies to monitor supply inventories and determine patient-specific supply needs. Coordinates equipment retrieval.<br/>Collects payments for deliveries when needed.<br/>Receives and responds to patient questions or complaints regarding services rendered.<br/>Completes and manages all delivery ticket paperwork and/or supportive documentation required for performing effective billing, in conjunction with the billing department.<br/>Prints shipping confirmation records or proof of delivery documentation.<br/>Manages and completes patient charts upon discharge.<br/>Coordinates with nursing to meet patient needs (i.e. drug or dose changes, line removals, unscheduled visit needs, etc.). Enter nursing visits into computer system as needed.<br/>Communicates changes in therapy to nurses and nursing agencies.<br/>Documents patient care-related activities and outcomes in progress notes.<br/>Answers incoming phone calls and triages to appropriate personnel.<br/>Participates in morning staff meetings with pharmacy, nursing and sales.<br/>Participates in departmental Quality Assurance (QA) activities as requested.<br/></p><p>Attends and participates in departmental and inter-departmental meetings as required.<br/></p><p>Performs other tasks or duties as requested.<br/></p><p>SKILLS AND ABILITIES:<br/></p><p>Demonstrated ability to communicate effectively both verbally and in writing with a strong emphasis on a customer first approach to resolutions.<br/>Good written and verbal communication skills<br/>Accurate keyboarding skills<br/>Computer/software literate with ability to navigate the internet<br/>Ability to work effectively with others.<br/>Demonstrates and maintains good organizational, time-management, and attention to detail skills.<br/>Proficient and accurate in data entry and use of a computer.<br/>Possess the ability and initiative to plan for and complete daily activities with minimal direction.<br/>Dependable in attendance and job performance.<br/></p><p>EDUCATION AND/OR EXPERIENCE:<br/></p><p>High school diploma. Some college education, certification, or degree preferred with a focus on a healthcare related field such as pharmacy technician training.<br/>Understanding and knowledge of basic drug terminology and pharmaceutical calculations.<br/></p><p>INTERPERSONAL RELATIONS/TEAMWORK:<br/></p><p>1. Demonstrates positive interpersonal relations in dealing with supervisors, co-workers and other employees so that productivity and positive employee relations are maximized.<br/>2. Exhibits a positive attitude toward the organization, his/her job and others.<br/>3. Shows concern and respect for others by dealing with people in a compassionate, sensitive and responsive manner.<br/>4. Promotes change and is proactive in suggesting change and new ways of doing things.<br/>5. Respects the confidentiality of others.<br/>6. Complies with company policies including employee handbook, quality improvement and safety guidelines.<br/></p><p>WORKING CONDITIONS/PHYSICAL DEMANDS:<br/></p><p>Work is typically performed in an office environment, as well as settings throughout the system and surrounding communities. Independent travel may be required.<br/>Consistently communicates and converses with leadership, employees, patients, and clients to exchange accurate information.<br/>Ability to listen to and understand information and ideas presented through spoken words and sentences.<br/>Consistently uses visual and hearing to assess patient need information.<br/>Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer in order to enter, transcribe, record, store or maintain information in written or electronic forms in order to manage patient care.<br/>Occasionally lifts, carries or otherwise moves and positions objects weighing up to 30 pounds.<br/>Typically bends, stoops and crouches on a regular basis.<br/></p><p>What we offer:<br/>Competitive compensation<br/>Benefits start on your 1st day of employment<br/>401k w 4% match &ndash; no waiting or vesting period<br/>PTO / Floating Holidays / Paid Holidays<br/>Company paid life insurance, short term disability<br/>Employee Assistance programs to help with mental health / wellness<br/>Learning &amp; Development Programs<br/>Perks&hellip; includes discounts on travel, cell phone, clothing and more&hellip;<br/>Generous employee referral program<br/>To learn more about KabaFusion, please visit our careers page: https://www.kabafusion.com/careers/<br/></p>

Pharmacy Care Coordinator

Equality Health

<div><p><b>Position Title: Pharmacy Care Coordinator</b></p><p><b>
Reports To:</b> <b>Supervisor, Clinical Outreach</b></p><p><b>
Classification: Exempt (Full-time)</b></p><p><b>
Places of Work: Remote (Preferred location: TX or TN)</b></p><p><b>
Work Expectations:</b></p><ul><li>
This is a remote, exempt position.</li><li>
Pharmacy Care Coordinators are assigned to a primary market and are expected to be available within that market&rsquo;s hours of operation (typically 8:00 AM &ndash; 6:00 PM local time).</li><li>
While each Pharmacy Care Coordinator is assigned a primary market, work priorities may shift based on business needs, and team members may support additional markets when required.</li></ul><p><b>
About the Role:</b></p><p>
The Pharmacy Care Coordinator will be primarily responsible for providing supportive care and assistance to a diverse patient population. This individual will be responsible for ensuring members are taking their medications as prescribed, understand their prescription benefits, and have the resources to obtain and pay for their medications. They will be a key part of our interdisciplinary team in identifying and removing social determinants of health and empowering our members to be involved in their healthcare journey.</p><p><b>
Key Responsibilities:</b></p><ul><li>
Conduct outbound phone calls to members to identify care needs and to determine appropriateness for participation in care coordination programs</li><li>
Outreach to members, providers, and pharmacies to discuss alternative medications, costs savings opportunities and adherence needs to improve HEDIS and STAR measures</li><li>
Contact patients, pharmacists and doctor's offices to research and resolve rejected and failed claims issues</li><li>
Work collaboratively with patients, network providers, pharmacist, referral coordinators, office and hospital staff; document all activities</li><li>
Report observations, symptoms and behaviors to appropriate healthcare professionals to ensure timely and effective intervention; Pharmacy Care Coordinators are prohibited from conducting evaluations or interpretations of clinical data</li><li>
Collect and analyze health plan data needed to implement and monitor quality improvement.</li><li>
Helping identify members who may be at-risk for medication non-adherence; identifying and acting to address specific drivers of medication non-adherence</li><li>
Schedule member appointments with our clinical pharmacist or complex care team for medication adherence issues or medication reconciliation</li><li>
Additional quality-related activities as identified that will improve patient and provider engagement and performance (preventive care visit, health screening and post-discharge related outreach)</li></ul><p><b>
Required Skills &amp; Qualifications:</b></p><div><ul><li>
Pharmacy Technician License or Nationally Certified Pharmacy Technician<ul><li>
Other certifications that may be considered include Certified Medical Assistant (CMA), Certified Nursing Assistant (CNA), Emergency Medical Technician (EMT)</li></ul></li><li>
Associate degree in healthcare or a related field of study; or, an equivalent combination of education and/or experience</li><li>
Minimum three (3) years of experience in a directly related position in the healthcare industry with high level of comfort around pharmacy &amp; medical terminology.</li><li>
Demonstrated experience caring for Medicare patients with a strong desire to work closely with aging patient populations</li><li>
Experience with pharmacy related quality assurance (e.g., medication reconciliation following hospital discharge and coordinating prescription refill programs)</li><li>
Excellent verbal, written and interpersonal communication skills; highly collaborative team approach to work</li><li>
Proficiency with Microsoft Excel and web-based technologies. Comfort using laptops, tablets and other electronic and portable devices for documentation</li></ul></div><p><b>
 </b><b>Preferred Skills &amp; Qualifications:</b></p><div><ul><li>
Bilingual &ndash; able to speak, read and write clearly and concisely in English and Spanish</li><li>
Previous experience with responsibility for pharmacy benefit management (PBM) or health plan managed care systems</li><li>
Experience with Medicare Part D operations (e.g., pharmacy help desk, utilization management, formulary management)</li><li>
Demonstrated knowledge and understanding of HEDIS metrics</li><li>
Experience working with a diverse population and a strong understanding of multicultural issues</li><li>
Strong problem-solving skills, including the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action</li><li>
Successful record of managing multiple projects with demonstrated ability to work independently in rapidly changing environments</li></ul></div><p></p><p><b><br>
About the Organization:</b></p><p>
Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.</p><p>
Through its supplemental care management services and proprietary technology platform, CareEmpower&trade;, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.</p><p>
In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities.</p><p><i>
Equality Health </i><i>provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.</i></p><p><i>
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.</i></p><p></p><p><i><br>
#LI-DM1</i></p></div>

Pharmacy Care Coordinator (Texas or Tennessee)

MedOne Benefit Solutions

<div><p><b>Overview: </b>MedOne is seeking a Certified Pharmacy Technician to deliver concierge-level support that helps members access specialty medications, including those sourced internationally. In this dynamic role, you'll guide patients through enrollment, financial assistance, and medication coordination while serving as a trusted liaison between providers, pharmacies, and care teams.</p><p><b>
About MedOne: </b>MedOne is a full-service pharmacy benefit manager (PBM), serving clients and members nationwide. With a fully</p><p>
transparent, pass-through model, MedOne helps people conveniently access the most appropriate prescriptions at the most affordable price.</p><p><b><br>
What You'll Do:</b></p><ul><li>
Support members in accessing resources and the appropriate site(s) of care, with specialty pharmacies, including internationally sourced partners</li><li>
Provide program and product specific financial knowledge</li><li>
Direct and support members with completion of enrollment requirements</li><li>
Convey pharmacy and claim details in easy-to-understand terms to callers</li><li>
Provide excelled member relations and concierge level style of services</li><li>
Comprehend and explain step therapy and copay requirements</li><li>
Act as a liaison between members, providers, pharmacies, and care facilities</li><li>
Coordinator scheduling of specialty medication delivery</li><li>
Utilize basic de-escalation techniques</li><li>
Maintain and be proactive with assigned case load and timely updates</li><li>
Prepare and provide clear communications verbally and in written formats</li><li>
Support operations of MedOne Member, Clinical, and Pharmacy services</li><li>
Align with, and support MedOne&rsquo;s Core Values</li></ul><p><b>
What You Will Bring to MedOne:</b></p><ul><li>
1 year minimum of customer service experience</li><li>
Pharmacy Technician Certification is highly encouraged. If you don't have it, you will be required to obtain it within one year of employment.</li><li>
Must obtain certification as a pharmacy technician within one year of hire date</li><li>
Strong knowledge of Microsoft Office products including Word, Excel, and Teams</li><li>
Customer empathy skills and proficiency in de-escalating challenging situations</li><li>
Excellent interpersonal, written, and verbal skills</li><li>
Detail orientated, able to work independently, meet deadlines, establish priorities, and be flexible</li><li>
Demonstrated ability to work effectively in a call center or office environment</li><li>
Must be able to stand/sit for long periods of time within limited space</li><li>
Must be able to life up 25 pounds</li></ul><p><b>
Why MedOne?</b></p><p>
At MedOne, we believe that a healthy team is a happy team. We offer a collaborative work environment, competitive benefits, and opportunities for growth&mdash;all while helping to make a difference in people&rsquo;s lives. Our top core value is to<b><i> prioritize your well-being</i></b><i>.</i></p><p>
To support you in living this value, we offer:</p><ul><li>
Competitive salary and bonuses that reward your performance.</li><li>
Comprehensive health, dental, and vision insurance + additional benefits</li><li>
401(k) with company match to secure your future.</li><li>
Generous paid time off and holidays.</li><li>
Opportunities for professional growth and development.</li><li>
A vibrant and collaborative work culture.</li></ul><p><b>
Location: </b>Offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States.<br>
<b>Employment Type: </b>Full Time, Hourly<br>
<b>Reports to: </b>Patient Care Coordinator Team Lead</p><p><b><br>
How to Apply:</b> If you're enthusiastic about helping others and eager to join a dynamic team, we&rsquo;d love to hear from you. Apply now and take the first step toward a rewarding career at MedOne! You can submit your application through our careers page.<br>
<br>
MedOne is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.<br>
<br>
Job Offers are contingent on passing a background check and drug screen.</p></div>

Specialty Pharmacy Patient Care Coordinator

The University of Kansas Health System

<div><div><div><div><div><div><div><div><h1 class="jobSectionHeader"><b>Position Title
</b></h1></div></div></div></div></div></div></div><p></p>Pharmacy Clinical Coordinator - Infusion Services
<p></p>South KC Medical Pavilion
<p></p><h2 class="jobSectionHeader"><b>Position Summary / Career Interest:
</b></h2>Join our Pharmacy team! This new Pharmacy Clinical Coordinator position will provide clinical support for Outpatient Non-Oncology and Home Infusion services teams.
<br>
<br>
The Pharmacist Coordinator provides comprehensive collaborative pharmaceutical care for patients. This consists of ensuring drug therapy that results in safe, effective, and cost-conscious use of pharmaceuticals. Must demonstrate excellent interdisciplinary communication and exhibit strong educational and precepting skills. This also includes education of healthcare professionals, guideline and protocol development, and implementation and analysis of data and outcomes. Through these activities, this position will support and expand clinical pharmacists' ability to perform daily monitoring of specific patients or regimens in relation to clinical area of expertise.
<p></p><p><b>Responsibilities and Essential Job Functions
</b></p><ul><li>Actively participates on the multidisciplinary team by consistently attending patient care rounds and providing patient &ndash; focused pharmaceutical care by assessing and monitoring drug therapy to ensure safe and cost &ndash; conscious treatment regimens.
</li><li>Actively supports department staffing needs by flexing to other areas or alternative scheduling in order to assist in coverage of supplemental shifts when primary team is in need.
</li><li>Assures timely medication order processing by participating in order entry, order verification and reviewing medication orders for timely resolution of problem orders.
</li><li>Continually reports medication incidents and adverse drug reactions in Patient Safety Net (PSN) and participates in medication incident review, peer review, or other activities to establish safe medication systems.
</li><li>Demonstrates personal effectiveness in leading the unit/team towards it goals and inspires a spirit of intra-team and inter-team cooperation.
</li><li>Identifies opportunities and needs for new or enhanced pharmacy services to support the mission of the organization and leads organizational and departmental performance improvement efforts to strengthen existing systems, processes, policies and procedures by introducing new ideas that lead to improved pharmaceutical care in clinical areas and in the pharmacy department as a whole.
</li><li>Identifies personal professional development needs and maintains a plan for continued growth.
</li><li>Maintains focus on all key stakeholders and supports the unit/team ability to deliver on all valid stakeholder expectations.
</li><li>Participates in projects resulting in contributions to pharmacy department, external publication and/or poster presentation for a local, regional, or national pharmacy association meeting.
</li><li>Shares pharmaceutical expertise by coordinating and providing educational presentations or in-services for pharmacy and non-pharmacy staff. Demonstrates excellence in personnel management by identifying strengths of team members and assisting employees in leveraging those strengths in their work.
</li><li>Supports pharmacy residency programs, clerkship students and interns by precepting organized rotations, providing timely and constructive feedback, participating in training and orientation, providing mentor-ship, and collaborating on presentations and projects.
</li><li>Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
</li>These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.<br>
<li>
</li></ul><p><br>
<b>Required Education and Experience
</b></p><ul><li>Bachelors Degree or Doctorate in Pharmacy
</li><li>Completion of an ASHP accredited PGY-1 and PGY-2 Pharmacy Residency Program OR
</li><li>Completion of an ASHP accredited PGY-1 Pharmacy Residency Program and 2 years of practice experience in area of focus OR
</li>3 or more years of practice experience in area of focus.<br>
<li>
</li></ul><p><br>
<b>Preferred Education and Experience
</b></p>Master's Degree in Pharmacy Administration, Health Administration or Business Administration<br>
<ul><li>
</li></ul><p><br>
<b>Required Licensure and Certification
</b></p><ul><li>Licensed Pharmacist - State Board of Pharmacy in state of primary practice site required within the first 120 days from start date
</li>Basic Cardiac Life Support (BLS or BCLS) - American Heart Association (AHA)<br>
<li>
</li></ul><p><br>
<b>Preferred Licensure and Certification
</b></p><ul><li>Neonatal Resuscitation Program (NRP) - American Academy of Pediatrics (AAP)
</li><li>PALS - Pediatric Advanced Life Support - American Heart Association (AHA)
</li><li>Advanced Cardiac Life Support (ACLS) - American Heart Association (AHA)
</li></ul><p></p><h2 class="jobSectionHeader"><b>Time Type:
</b></h2><p></p><h2 class="jobSectionHeader"><b>Job Requisition ID:
</b></h2>R-51838
<p></p><h3 class="jobSectionHeader"><b>Important information for you to know as you apply:
</b></h3><ul><li><p>The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. <i>See also </i>Diversity, Equity &amp; Inclusion <i>.
</i></p></li><li><p>The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link asktalentacquisition@kumc.edu .
</p></li><li><p>Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.
</p></li></ul><p></p><h2 class="jobSectionHeader"><b>Need help finding the right job?
</b></h2><p></p><p>We can recommend jobs specifically for you! Create a custom Job Alert by selecting criteria that suit your career interests.</p></div>

Pharmacy Clinical Coordinator - Infusion Services

UChicago Medicine

<div>Job Description:
<div>
Be a part of a world-class academic healthcare system at <b>UChicago Medicine</b> as an <b>Ambulatory Medication Access Coordinator </b>in the <b>Specialty Pharmacy</b>. In this role you will be responsible for handling inbound and outbound phone calls, conducting and completing necessary third party (insurance) prior authorization requests and associated services related to high-cost medications, maximizing efficiency for patients and clinic staff.</div><div><br>
</div><div>In this role, the Ambulatory Medication Access Coordinator, or AMAC, performs necessary functions to ensure optimal reimbursement for high cost, take home medications for patients receiving care in UCMC Ambulatory Clinics. Other areas of responsibility include handling inbound and outbound phone calls, pre-screening patients for viable payment sources, managing reimbursement issues associated with high-cost, take-home medications, identifying opportunities for improving reimbursement from payers, and completing necessary paperwork for prior authorizations.</div><div></div><div><b><br>
Eligible for a Sign-On Bonus up to $3,000</b></div><div></div><div><b><br>
Essential Job Functions</b></div><ul><li>
Improve patient service experience and maximize UCMC pharmacy revenue through provision of prior authorization services on behalf of clinics for select high-cost medications.</li><li>
Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete prior authorization forms, negotiate authorization status with insurers, track status of prescription approval and when necessary, alert clinical pharmacists of denials or nonresponse.</li><li>
Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance.</li><li>
Enter patient information on tracking forms and in computer software.</li><li>
Expedite clinic workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, and clinic staff.</li><li>
Provide exemplary customer service to outpatients across UCMC, including handling inbound and outbound phone calls.</li><li>
Observe and understand prescribing trends within UCMC Ambulatory Clinics to identify areas for improved specialty pharmacy contracting.</li><li>
Assist with development and implementation of policies and procedures to ensure reimbursement of high-cost medications.</li><li>
Performs other duties as requested by leadership.</li></ul><div><b>
 Required Qualifications</b></div><ul><li>
Associate's or Bachelor&rsquo;s degree</li><li>
Current or Eligibility for Illinois Pharmacy Technician licensure</li><li>
3 to 5 years of pharmacy technician experience in a retail pharmacy (exceptional aptitude or knowledge may be considered in lieu of experience.)</li><li>
Knowledge of and ability to use computers and a variety of computer programs including word processing, database management and spreadsheets</li><li>
Strong oral and written communications skills</li><li>
Ability to effectively manage conflicts and resolve problems</li><li>
Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction</li><li>
Ability to function effectively in a fast-paced and changing environment with multiple priorities</li><li>
Knowledge of and ability to perform insurance carrier/managed care review</li></ul><div><b>
 Preferred Qualifications</b></div><ul><li>
Knowledge of medication reimbursement preferred</li><li>
Knowledge of healthcare/prescription insurance billing, prior authorization, coding preferred</li></ul><div><b>
 Position Details</b></div><ul><li>
Job Type/FTE: Full-Time (1.0 FTE)</li><li>
Shift: Days</li><li>
Work Location: Hyde Park</li><li>
Unit/Department: Specialty Pharmacy</li><li>
CBA Code: Non-Union</li></ul><div></div><div><br>
In this role, we anticipate that you will be scheduled to work 8-hour shifts, day shift approximately between the hours of 7am-5:30pm and will not be scheduled for on-call shifts. We anticipate you will be scheduled to work a remote-hybrid schedule, working onsite 1 week every 3-5 weeks. The days of the week that you are scheduled will be Monday-Friday, and no weekends. This is subject to change.</div>
Why Join Us:
<div><i>
We&rsquo;ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment&hellip; with patients and with each other. We&rsquo;re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you&rsquo;d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we&rsquo;re doing work that really matters. Join us. Bring your passion.</i></div><div></div><div><i><br>
UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: </i><i>UChicago Medicine Career Opportunities</i><i>.</i></div><div></div><div><i><br>
UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.</i></div><div></div><div><i><br>
Must comply with UChicago Medicine&rsquo;s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.</i></div><div></div><div><b><i><br>
Compensation &amp; Benefits Overview</i></b></div><div></div><div><i><br>
UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.</i></div><div></div><div><i><br>
The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.</i></div><div></div><div><i><br>
Review the full complement of benefit options for eligible roles at </i><i>Benefits - UChicago Medicine</i><i>.</i></div></div>

Ambulatory Medication Access Coordinator (Specialty Pharmacy), Full-Time, Rotational

Medical Mutual

<div>
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  <li>
   We are seeking candidates who are currently based in Ohio for this role.
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  </li>
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 Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
 <br/>
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 <strong>
  Medicare Pharmacy Coordinator I
  <br/>
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   Job Summary:
   <br/>
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  </strong>
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 Working under general supervision, administers typically more standardized or routine daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part C (medical drug) benefit programs. Configures, implements, maintains, and services Medicare and Individual pharmacy benefits, with a strong focus on member experience.
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   Responsibilities:
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   Coordinates pharmacy reject review and resolution either directly or forwards/escalates to other departments or PBM. Monitors paid claims for accuracy including for transition supply oversight. Ensures timely communication to members on coverage determination and prescriptions with timeframe restrictions, assesses coverage review accuracy, and triages as needed.
  </li>
  <li>
   Assists in outbound calls to members, providers, and pharmacies to initiate coverage determinations/appeals, prescription refills, and switch members to lower cost therapeutic alternatives based on discussions with providers. Documents all attempts in tracking software.
  </li>
  <li>
   Collaborates with Clinical Intervention Pharmacists on Medicare Stars and other quality initiatives, with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members to provide status of intervention.
  </li>
  <li>
   Tracks and coordinates daily issue/response files with PBM for claim resolution. Outreaches to pharmacy/prescriber as needed.
  </li>
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   Generates reports from pharmacy system and reviews production metrics. .
  </li>
  <li>
   Supports operational oversight overflow and any additional requests. Responds to Part D and Part B benefit questions, updates tracking documents, and ensures effectuation of claims.
  </li>
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   Builds and maintains knowledge of new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals, Grievances, and Medicare marketing material requirements.
  </li>
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   Assists in internal and external audits and projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as needed.
  </li>
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   Performs other duties as assigned.
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  </li>
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   Qualifications:
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  Education and Experience:
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   Associate Degree in Business Administration, Healthcare, or related field or equivalent combination of experience, training, and education.
  </li>
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   4 &ndash; 5 years of experience in a health plan, pharmacy, or PBM operations, which includes exposure to Centers for Medicare &amp; Medicaid Services (CMS) guidelines, preferably Part D.
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  </li>
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 <strong>
  <strong>
   Professional Certification(s):
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Certified Pharmacy Technician (CPhT) preferred.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   Technical Skills And Knowledge:
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Knowledge of CMS guidelines and Medicare Part D (pharmacy).
  </li>
  <li>
   Knowledge of pharmacy claims processing through retail or mail pharmacy.
  </li>
  <li>
   Intermediate Microsoft Office skills (Excel, Word, Power Point).
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Medicare Pharmacy Coordinator II
  <br/>
  <br/>
 </strong>
 <strong>
  <strong>
   Job Summary:
   <br/>
   <br/>
  </strong>
 </strong>
 Working under general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part C (medical drug) benefit programs. Configures, implements, maintains, and services Medicare and Individual pharmacy benefits, with a strong focus on member experience.
 <br/>
 <br/>
 <strong>
  <strong>
   Responsibilities:
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Coordinates pharmacy reject review and resolution either directly or forwards/escalates to other departments or PBM. Monitors paid claims for accuracy including for transition supply oversight. Ensures timely communication to members on Part D coverage determination, all levels of appeal, re-openings (case re-decision) and Part C organization determination, and prescriptions with timeframe restrictions, assesses coverage review accuracy, and triages as needed.
  </li>
  <li>
   Coordinates remediation efforts for Hospice and End Stage Renal Disease (ESRD) processes.
  </li>
  <li>
   Supports Medicare Pharmacy Specialists in the research and review of Part D and Part B inquiries, grievances, and CTMs, updating tracking documents, audit research items, and marketing material reviews.
  </li>
  <li>
   Assists in outbound calls to members, providers, and pharmacies to initiate coverage determinations/appeals, prescription refills, and switch members to lower cost therapeutic alternatives based on discussions with providers. Documents all attempts in tracking software.
  </li>
  <li>
   Collaborates with Clinical Intervention Pharmacists on Medicare Stars and other quality initiatives, with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members to provide status of intervention.
  </li>
  <li>
   Generates reports from pharmacy system and reviews production metrics. Conducts Part D Explanation of Benefits (EOB) audit.
  </li>
  <li>
   Tracks and coordinates daily issue/response files with PBM for claim resolution. Outreaches to pharmacy/prescriber as needed. Supports operational oversight overflow and any additional requests. Responds to Part D and Part B benefit questions, updates tracking documents, and ensures effectuation of claims.
  </li>
  <li>
   Maintains knowledge of new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals, Grievances, and Medicare marketing material requirements. Assists in internal and external audits and projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as needed.
  </li>
  <li>
   Assists more junior level with any oversight process questions.
  </li>
  <li>
   Performs other duties as assigned.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   Education And Experience:
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Associate Degree in Business Administration, Healthcare, or related field or equivalent combination of experience, training, and education.
  </li>
  <li>
   1-2 years of experience as a Medicare Pharmacy Coordinator or equivalent 5-6 years of experience in a health plan, pharmacy, or PBM operations, which includes exposure to Centers for Medicare &amp; Medicaid Services (CMS) guidelines, specifically Part D.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   Technical Skills And Knowledge:
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Strong knowledge of CMS guidelines and Medicare Part D (pharmacy).
  </li>
  <li>
   Strong knowledge of pharmacy claims processing through retail or mail pharmacy.
  </li>
  <li>
   Intermediate Microsoft Office skills (Excel, Word, Power Point).
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  A Great Place To Work:
  <br/>
  <br/>
 </strong>
 Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
 <br/>
 <br/>
 <ul>
  <li>
   We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
  </li>
  <li>
   Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
  </li>
  <li>
   On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
  </li>
  <li>
   Discounts at many places in and around town, just for being a Medical Mutual team member.
  </li>
  <li>
   The opportunity to earn cash rewards for shopping with our customers.
  </li>
  <li>
   Business casual attire, including jeans.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Excellent Benefits And Compensation:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Employee bonus program.
  </li>
  <li>
   401(k) with company match up to 4% and an additional company contribution.
  </li>
  <li>
   Health Savings Account with a company matching contribution.
  </li>
  <li>
   Excellent medical, dental, vision, life and disability insurance &mdash; insurance is what we do best, and we make affordable coverage for our team a priority.
  </li>
  <li>
   Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
  </li>
  <li>
   Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
  </li>
  <li>
   After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  An Investment In You:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Career development programs and classes.
  </li>
  <li>
   Mentoring and coaching to help you advance in your career.
  </li>
  <li>
   Tuition reimbursement up to $5,250 per year, the IRS maximum.
  </li>
  <li>
   Diverse, inclusive and welcoming culture with Business Resource Groups.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  About Medical Mutual:
  <br/>
  <br/>
 </strong>
 Medical Mutual&rsquo;s status as a mutual company means we are owned by our policyholders, not stockholders, so we don&rsquo;t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
 <br/>
 <br/>
 There&rsquo;s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
 <br/>
 <br/>
 We&rsquo;re not just one of the largest health insurance companies based in Ohio, we&rsquo;re also the longest running. Founded in 1934, we&rsquo;re proud of our rich history with the communities where we live and work.
 <br/>
 <br/>
 <em>
  We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
  <br/>
  <br/>
 </em>
</div>


Medicare Pharmacy Coordinator

Froedtert Health

<div><div><p>Discover. Achieve. Succeed.
</p><p>#BeHere</p><br>
</div><p></p><div><div><p>Location: US:WI:MENOMONEE FALLS at our INTEGRATED SERVICE CENTER facility.</p>
</div></div><div><p>This job is HYBRID.</p></div><div><div><p>
FTE: 1.000000</p></div></div><div>
<p>Standard Hours: 40.00</p></div><div><div><p>
Shift: 1</p></div></div><p></p><div><p>
Schedule:
</p>Monday-Friday, First shift, no weekends or holidays</div><p></p><div><p>
Job Summary:</p></div><p>
The Medication Access Coordinator is responsible for coordinating the efforts around prior authorizations for medications billed through patients' pharmacy &amp; medical benefits, patient assistance workflows, ensuring accurate billing and reimbursement for pharmacy services, and around the prescription refill workflows and protocol maintenance. The position will operate as a liaison between the Medication Access team, clinic leadership, clinical staff, providers, insurance providers and other involved parties to provide safe and efficient care to all patients impacted by the medication access team. Remote access may be required for timely work completion due to the time sensitivity around these services. Responsible for oversight of obtaining medication insurance coverage or assistance and benefit information, authorizations of medications, monitors patient's insurance status, assists in facilitating medication refill requests, and communicates insurance issues to the treatment team. Coordinates the day to day functions on the Medication access team to ensure timeliness of all services and ensure proper follow up is done by team members. Responsible for providing updates around medication access services to physicians, clinical staff, and pharmacy office, through multiple methods as appropriate (includes in services, email communication, one on one meetings). Coordinate the research, design, and implementation of practices and processes for medication access services. Other duties as assigned.
</p><div><p>EXPERIENCE DESCRIPTION:
</p></div><p>A minimum of 2 years experience as a Medication Access Specialist 2 (or similar experience). Cross trained and demonstrated ability to support prior authorization services in a minimum of 3 different disease states and/or demonstrated ability to support multiple clinics from a medication refill perspective and/or demonstrated ability to support all areas in regards to foundation and manufacture assistance. Cross trained and demonstrated competence in multiple medication access team responsibilities (such as prior authorizations, foundation and manufacture assistance, and medication refill support). Experience with 3rd party insurance.
</p><div><p>EDUCATION DESCRIPTION:
</p></div><p>High school diploma or equivalent is required. 4 year degree preferred. Graduate of ASHP accredited pharmacy tech training program preferred.
</p><div><p>SPECIAL SKILLS DESCRIPTION:
</p></div><p>Proven attention to detail. Exceptional customer service skills. Proven ability to communicate effectively with a diverse group. Outstanding organizational skills. Promotion skills ability to sell a program. Experience with various computer systems, programs, and insurance companies (such as EMR, retail pharmacy POS, web portals). Ability to independently facilitate new projects and work with a multidisciplinary group to achieve success. Aptitude for accomplishing goals with minimal supervision and working independently with efficiency and self-motivation. Critical thinking skills to improve upon current processes and suggest solutions to problems with the services.
</p><div><p>LICENSURE DESCRIPTION:
</p></div><p>Application for Wisconsin registration as a Pharmacy Technician is required by hire date and must be obtained within 12 months of hire. Staff hired into this role prior to 3/31/23 must have applied for Wisconsin registration by 3/31/23 and have until 3/31/24 to obtain registration. Certification as a Pharmacy Technician (CPhT) through passing the Pharmacy Technician Certification Boards exam (PTCE) or the National Healthcareer Associations exam (ExCPT) is required within 6 months of hire.<br>
</p><p></p><br>
<div><p>Perks &amp; Benefits at Froedtert Health
</p></div><p>Froedtert Health Offers a variety of perks &amp; benefits to staff, depending on your role you may be eligible for the following:
</p><ul><li>Paid time off</li><li>
Growth opportunity- Career Pathways &amp; Career Tuition Assistance, CEU opportunities</li><li>
Academic Partnership with the Medical College of Wisconsin</li><li>
Referral bonuses</li><li>
Retirement plan - 403b</li><li>
Medical, Dental, Vision, Life Insurance, Short &amp; Long Term Disability, Free Workplace Clinics</li>
Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available<br>
<li>
</li></ul><p></p><br>
<p>The Froedtert &amp; the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert &amp; MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.
</p><p></p><div><p><i>We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.</i></p></div></div><p></p>

Medication Access Coordinator

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