Pediatric Pharmacy Technician Specialist

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

MCJCHV Rx Services

Job Summary:

JOB SUMMARY
Facilitates communication between the provider team and pharmacy to prevent any delays in medication therapy and any challenges related to coverage, cost, or patient location. Works with multidisciplinary groups to develop processes to improve adherence and availability of medications within scope of clinic. Works with nursing staff, providers, and pharmacy team to obtain prior authorizations, medication appeals, set up mail and coordinate onsite delivery. Utilizes knowledge of pharmacy system to run test claims and communicates with provider, families, or patients directly. May also include the following:

Evaluates reimbursement of medications provided to inpatients, clinic patients and patients receiving prescriptions through the outpatient pharmacy network. Works with multidisciplinary groups to develop proper procedures and programs to maximize reimbursement. Facilitates process and system improvements to reduce the likelihood of occurrence of loss of reimbursement relating to pharmaceuticals. Assists with maintaining drug and payer data files in the dispensing system. Works with dispensing staff and/or Payor Help Desk Staff to troubleshoot issues with medication claims &, when needed, editing / resubmitting claims in the OP dispensing system.

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Preferred Qualifications

• Registered Pharmacy Technician
• Tennessee Board of Pharmacy Technician Registration must be obtained within 90 days of employment
• PTCB/CPT National Pharmacy Technician Certification
• 2 years Relevant Work Experience
• Per Pharmacy Department policy, all new hires are subject to preemployment drug screening (post offer), as well as for cause and random drug screening during their tenure with Vanderbilt.

Responsibilities
Technician will be delivering medications to patient bedside and communicating with nursing staff or providers directly.  Required Skills; Effective communication, strong organization skills, and leadership skills to handle challenging situations.

KEY RESPONSIBILITIES
• Utilizes pharmacy software to run test claims on insurance.
• Evaluates the need for prior authorization and ability for patient’s disease state to be approved for that medication.
• Works with pharmacy staff to coordinate mail set up and/or pick up for patients who are coming from clinic.
• Works with pharmacists, providers, and nurses to communicate challenges for prescriptions, including denials and appeals.
• Assists clinic pharmacist with in-basket messaging and communicate when she is absent.
• Communicate with patients and families about their prescriptions to set up mail or coordinate the prescription being transferred.
• Utilize knowledge of Patient Assistance Programs (PAP) and Medication Assistance Programs (MAP) to apply when needed.

• Answer questions from the provider team or directly from patients when applicable.
• Collaborates with the pharmacy team to improve patient care and adherence.

May Also Include the Following Responsibilities:
• Clarify and trend pharmaceutical denials and underpayments of the highest cost drugs and other drugs.
• Utilizes data from finance and pharmacy systems to determine reimbursement rates for pharmaceuticals for various patient care settings.
• Evaluates actual reimbursement compared to defined contractual reimbursement rates for specific drugs/procedures.
• Provides trending on reimbursement and information on areas for focus to maximize reimbursement.
• Maintains data in appropriate database to facilitate evaluation and presentation of data.
• Evaluates data enabling the identification of trends by multiple variables.
• Work with patient accounting, finance, contracts and pharmacy to develop strategy for improved reimbursement.
• Utilizing data collected, define