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.
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.
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.