Specialty Pharmacy Liaison Certified

Where You’ll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Job Summary and Responsibilities

Specialty pharmacy provides complex, high dollar medication therapies to patients with serious and life threatening health conditions such as transplant, HIV, multiple sclerosis, and cancer. These medications require special handling and intensive patient management touchpoints to ensure patient medication adherence to lower overall healthcare costs and reduce readmission rates. The specialty pharmacy liaison is responsible for the intensive patient care management. The specialty pharmacy liaison represents the CommonSpirit Health Specialty Pharmacy and operates as a liaison between the provider staff, patient, pharmacy, billing, insurance provider, patient communities, social services and other involved parties to drive excellent customer service delivery and a full continuum of patient care. By coordinating with these groups they can ensure each medication is delivered on time and is affordable for the patients they work with. They are responsible for increasing prescription capture, medication adherence, and patient retention with the use of various tools and applications. They will encourage patients of specialty clinics and employees to utilize pharmacy to fully benefit from its superior patient care services.

To be successful in this role you will possess expert communication skills to interact with staff, physicians, and committees, effectively manage clinical competencies, and consistently support the strategic goals of the pharmacy department.

• Specialty pharmacy operations: Assist in marketing efforts to patients and providers to increase revenue, capture patient prescription volume, and improve patient retention by understanding business goals. Inform pharmacy leaders about changes in the marketplace and physician patterns. Inform system manager about issues with workflow and communication between patient, specialty clinic, and Specialty Pharmacy teams. Actively participate in process improvement standards. Is present at provider and community outreach events as appropriate. Actively participates in the accreditation process by understanding and performing the expectations of a liaison and patient care management within the standards. Stays up to date on all training needed for the job as well as maintaining accreditation standards and changes. May perform prescription dispensing duties (ie data entry, filling, selling)
• Prescription management: Act as an insurance specialist by expediting the prescription filling process (entering patient demographics, allergies, insurance information); obtain benefit information, verify patient insurance eligibility and level of coverage; understand Medicare/Medicaid regulations and billing guidelines as they pertain to Specialty Pharmacy patient benefits; understand billing primary, secondary and tertiary insurance claims. Process medication orders confirming that they are billed to all third parties correctly. Initiate and assist with the Prior Authorization and Patient Prescription Financial Assistance processes within the assigned disease state. Coordinate medication deliveries/pick-ups with the dispensing pharmacy after patient communication to include, completed delivery slip, storage/shipping needs, ancillary supplies needed, etc.
• Patient and provider services: Exemplifies excellent customer service during interactions with patients, employees, providers and others to build the Specialty Pharmacy program. Represent on-site/off-site Specialty Pharmacy seamlessly, answer patient and provider staff questions about the service, insurance issues, etc.; assist stakeholders with data interpretation and provide recommendations for improvement of quality. Work with the referring provider and/or clinic staff along with the patient care management program to ensure that patients receive the medications needed at the appropriate time. Communicate with patients in-person, and over the phone through inbound/outbound calls, to ensure adherence with medications through prescription refills and adherence check-ins. Monitor patient charts and profiles in an effort to meet Specialty Pharmacy therapy needs. Influence and motivate others to coordinate projects, resources and people to achieve the implementation of Specialty Pharmacy services.
• Medication management: Review medication regimen with pharmacists to determine which medications need to be dispensed on a timely schedule. Stays informed of medications available within the pharmacy and in the industry in relation to their assigned disease state(s). Participate in clinical training for Specialty disease states.

Job Requirements

Required Education and Experience

• High School Graduate and active Pharmacy Technician license
• 4-5 years as a pharmacy technician or a combination of education and related experience may be considered
• Pharmacy Tech license
• Certified Pharmacy Tech PTCB, ECPT or CPHT certification

*Compensation is determined by the location where the work is being conducted, candidate experience, and internal equity of the department.