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Banner Health Senior Pharmacy Patient Advocate in Phoenix, Arizona

Primary City/State:

Phoenix, Arizona

Department Name:

Specialty Pharmacy

Work Shift:

Day

Job Category:

Pharmacy

A position in a Banner Health pharmacy is one you can look forward to. Join an engaging environment of full service, high technology and experience a wide variety of responsibilities. You’ll also see how important a pharmacy job is to our ability to make life easier for our patients. Come enjoy great challenges and build both your knowledge of the field and your analytical skills.

This position will be hired into the newly formed Pharmacy Shared Services. This position will support Banner Family Pharmacy - Home Delivery and Banner Pharmacy Services - Specialty Care. This Department is responsible to provide direct patient care to patients and their caregivers by assisting with financial assistance and prior authorizations.

As a Pharmacy Patient Advocate technician and provider consultation, providing pharmacist verification and fulfilment. You will have the opportunity to work in a very rewarding line of work, with a high functioning team that offers opportunity for professional growth. In addition you will be able to work within the hours of 8am-5pm, no weekends or holidays, with flexible hours during the week. This position is located in Chandler.

Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.

Banner Pharmacy Services division provides excellent patient care across our entire continuum through convenient access, improved medication outcomes and innovative pharmacy practices. Banner Pharmacy Services will be recognized nationally as a clinical leader and trusted partner in proactively providing innovative pharmacy services through excellence in integration, care coordination, medication management and service to make a difference in people's lives. Banner is expanding its focus from being a hospital company to a clinical quality company focused on population health management. Clinical Pharmacy Services are also included in this robust new service line and are responsible for the management of the Banner formulary, development of standardized system wide clinical pharmacy services, and management of adverse drug event preventions. Clinical Pharmacy Services provides collaborative drug therapy management and educational interventions in patient care to optimize medication therapy, improve outcomes, promote wellness, and disease prevention.

POSITION SUMMARY

This position will work under the supervision of the pharmacist and/or technician supervisor. This position serves as a liaison to coordinates pharmaceutical care services (specialty pharmacy services, home infusion, clinic-based infusion, or other medication therapies) through communication with the prescribers and their support staff, health insurance and pharmacy benefit manager representatives, patient assistance programs, foundations, Banner revenue cycle, and other stakeholders. Will also take requests for prescription refills and obtain necessary prior authorizations. Available, as scheduled, to answer inbound calls while protecting the confidentiality of member information and adhering to company policies regarding patient health information (PHI). Makes outbound calls as needed, faxes providers offices, and provides exceptional, courteous and professional customer service. May perform supervisory functions as related to workflow and/or function as the responsible individual in specialty function or area. Provides education to referring providers regarding coordination of benefits and other financial resources, REMS requirements, and other operational updates. Delivers summary data to referring providers regarding the therapy status of patients referred to a Banner Family Pharmacy service line.

CORE FUNCTIONS

  1. Coordinates and assists in supervising the work flow of the Pharmacy Patient Advocates. Assists the Technician Supervisor with training and completing performance appraisals. Ensures technician staff adherence to departmental policies and procedures. Assists in scheduling to assure staffing is at appropriate levels and is responsible for filling in during absences. Responsible for the operation of a specific area to ensure workflows are being followed as stated in Policies and Procedures and that contractual and regulatory metrics are being met. Assists in monitoring and tracking of support center metric requirements as outlined by the applicable contracts.

  2. Researches clinical data necessary to complete and maintain prior authorization, and interfaces with prescribers to ensure that referrals are complete and include all necessary clinical and demographic information. Monitors health insurance and pharmacy benefits market and communicates changes across service lines. However, PPAs are prohibited from conducting evaluation or interpretation of clinical data.

  3. Performs test claims to determine copayment/coinsurance amounts, with applicable patient assistance programs. Understand copays, formularies and special pricing to ensure claims are adjudicated correctly and adjustments are performed when applicable.

  4. Input orders efficiently with attention to detail, includes order entry, billing, crediting, and updating medical records. Meet departmental standards for production and quality improvement strategies, schedule adherence as well as participate in training and self-development opportunities when appropriate.

  5. Provides ongoing supports to providers who prescribe therapies that require a high degree of care coordination and patient assistance through education, and problem-solving. Provides education to providers and office staff in regard to prescribing/documentation standards, changes in payer formularies, prior authorizations, and REMS.

  6. Understands billing regulations and guidelines and maintains a high degree of knowledge in pharmacy claims processing and patient assistance programs. Liaises with pharmacy patient advocates to communicate issues, changes in therapy plan, or other issues throughout a patient’s course of therapy.

  7. Participates in sales/business development efforts.

  8. Facilitates communication and issue resolution across a diverse array of stakeholders.

MINIMUM QUALIFICATIONS

Skills and knowledge typically attained with acquiring a Pharmacy Technician License.

Requires knowledge of drugs, medical nomenclature, and the metric system to enter data into the computer system to fill prescriptions and to obtain reimbursement/payment. Must demonstrate the ability to research complex issues across multiple databases, work with support resources to resolve member issues, and own problems through to resolution on behalf of the member in real time or follow-up with the member as soon as possible. Must demonstrate 5+ years of experience performing in a pharmacy technician role. Must demonstrate 1+ years of experience as a pharmacy patient advocate. Must possess good organizational, problem solving and computer skills. Must have good written and verbal communication skills for interfacing with all levels of staff, physicians, patients and other contacts. Previous experiences working with pharmacy benefit managers, insurance verification, or patient assistance.

PREFERRED QUALIFICATIONS

Pharmacy Technician Certification Board (PTCB) certification.

Additional related education and/or experience preferred.

DATE APPROVED 11/04/2018

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability.

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