Job Details The Specialty Pharmacist Navigator seeks relationships with physicians and physician practices who use specialty pharmaceuticals for the purpose of prescribing the medications, training, and assisting patients.
Location: On-site at a specified location in Denver, CO
Responsibilities:- Access various physician practices for potential specialty Rx value using tools/data available.
- Establish communication with targeted specialty practices, arranging meetings with key stakeholders/decision makers.
- Demonstrate value of ambulatory pharmacy partnership to specialty practices.
- Ensure prescriptions flow through to ambulatory pharmacy and are identified by pharmacy staff.
- Establish patient profiles, including third-party payor(s) and clinical information.
- Process prescriptions, including insurance adjudication and product sourcing.
- Prepare and submit prior authorization paperwork; manage denials.
- Triage prescriptions which are limited distribution drugs or out-of-network.
- Act as financial advocate for patient where needed; leverage charitable foundations, state programs, and/or manufacturer programs to ensure maximal patient access
- Coordinate pickup/courier delivery of Rx's with patient.
- Follow up with patient to ensure refills are ordered on time and address and ADR's or clinical questions.
- Inform physician office of patient through process; document in EMR as necessary.
- Maintain relationships with physician offices through periodic visits/meetings.
- Assist with program financial reporting to client/data collection.
- Cross-train to ambulatory pharmacy; assist with staffing needs as required. This may include weekends and/or holidays as per business needs.
- Provide oversight and direction to associates in accordance with the organization's policies and procedures.
- Coach, mentor, and develop staff, including overseeing new employee onboarding and providing career development and opportunities.
Education:Current unrestricted pharmacist license in the appropriate state of practice,PharmD degree strongly preferred.
5+ years community/retail/ambulatory pharmacy or health-system related experience. Previous experience in a specialty pharmacy and/or processing prior authorizations is highly desirable.
Skills and Knowledge:- Must be proficient in Microsoft Office, including Word, Excel, and PowerPoint
- Candidates should have prior experience on pharmacy dispensing systems and be familiar with insurance adjudication processes.
- The role involves working with a broad array of complex disease states and medical conditions; candidates should be comfortable working with clinical data, lab values, and reading/writing notes in patient medical records.
#LI-DL1
Full time
Salary Range*$100,700 - 155,100
*This Salary Range reflects a National Average for this job. The actual range may vary based on your locale. Ranges in Colorado/California/Washington/New York/Hawaii/Vermont/Minnesota/Massachusetts/Illinois State-specific locations may be up to 10% lower than the minimum salary range, and 12% higher than the maximum salary range.
Affiliated Companies:Affiliated Companies: Value Apothecaries Inc
