Leads and guides team by acting as a liaison between patients, prescribers, pharmacies, and payers and collaborates with members of the interprofessional team to promote timely access to medications. Leads daily operations of pharmacy benefits investigation, oversees financial assistance and facilitation of prior authorizations, as required.
Job Responsibility
1.Collaborates with inter-professional team to enhance communication, coordinate care, and improve patient satisfaction.
2.Leads team as a subject matter expert on outpatient pharmacy services, prescription insurance benefits, and financial assistance.
3.Leads team on patient cases and is responsible for training/mentoring team members on technical skills.
4.Partners with patients to determine most appropriate sources for their medication needs and refers patients to appropriate programs and resources.
5.Reviews prescriptions with outpatient pharmacies to confirm which medications need to be dispensed and provides necessary timeline for dispensing.
6.Resolves insurance related issues and coordinates prior authorization requirements.
7.Exhibits exceptional customer service during interactions with patients, caregivers, and other health care professionals.
8.Makes recommendations to leaders with respect to program impact and areas for improvement to site and organizational leadership. 9. Researches and resolves complex prior authorizations including letters of medical necessity, and supervises team members with complicated authorization or financial assistance tasks. 10. Makes decisions regarding daily priorities and provide guidance to team members on non-routine or escalated issues. 11.May have functional supervision responsibilities, coordinate scheduling of work assignments, and direct daily priorities of team members. 12. May provide input into performance reviews and corrective actions for team members.
13. Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Job Qualification
• Associate's/Technical Degree or equivalent combination of education and related experience.
• 5-7 years of relevant experience, required.
*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
Northwell Health is New York State’s largest health care provider and private employer, with 28 hospitals, about 1,000+ outpatient facilities and more than 16,000 affiliated physicians.
At Northwell, we focus on cultivating an environment that inspires growth, empowers leadership, and encourages breakthroughs, not just in the communities we serve but in the careers of those who make an impact in the lives of so many. We are committed to our mission and our core values – including being Truly Inclusive. We value everyone’s perspectives, backgrounds and experiences. This is demonstrated in the work we do together, and how we care for each other, our patients, their families and the communities we serve.
We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 100,000+ employees – 19,000+ nurses and 5,000+ employed doctors, including members of Northwell Health Physician Partners – are working to change health care for the better.
We’re making breakthroughs in medicine at The Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies.
For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, X, Instagram and LinkedIn.
Interested in a career at Northwell Health? Visit Jobs.Northwell.edu and explore our many opportunities.
