Pharmacy Patient Advocate

Primary City/State:

Gilbert, Arizona

Department Name:

Patient Advisory

Work Shift:

Day

Job Category:

Pharmacy

*UP TO A $5,000 SIGN ON BONUS AVAILABLE*

Pharmacy careers are better at Banner Health. We are committed to developing the careers of our team members. We care about you, your career today and your future. If you’re looking to leverage your abilities – apply today.  

Banner MD Anderson combines Banner Health, one of the country’s largest nonprofit hospital systems, with MD Anderson, internationally renowned for its cancer treatment and research, to deliver unprecedented levels of cancer care in Arizona.

We are looking for a Pharmacy Patient Advocate to join our team at Banner MD Anderson Cancer Center in Gilbert. Having retail and/or hospital pharmacy experience, along with prior authorization experience will be helpful in this role. Your schedule will be Monday through Friday, 8AM - 4:30PM, excluding holidays.

Recruiter to provide sign-on eligibility during the interview process.

Banner Pharmacy Services is a recognized leader in healthcare and trusted partner in proactively providing innovative pharmacy services through excellence in integration, care coordination, medication management and services to make a difference in people's lives. Clinical Pharmacy Services is 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. As a division, Banner Pharmacy services provides excellent patient care across our entire continuum through convenient access, improved medication outcomes and innovative pharmacy practices.

POSITION SUMMARY
This position will work under the supervision of the pharmacist and/or technician supervisor. 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. Serves as a liaison between the customer and the pharmacists, physicians, and third party administrators. 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. 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.

CORE FUNCTIONS
1. 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. However, PPAs are prohibited from conducting evaluation or interpretation of clinical data.

2. 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.

3. Builds and maintains strong relationships with patients, and serves a primary point-of-contact throughout the duration of therapy. Educates the patient about coordination of benefits and plan of care.

4. Obtains applicable financial resources, such as patient assistance and foundation grant support, to assist in covering the patient's portion of therapy. Interfaces with revenue cycle to establish payment plans, when necessary, and coordinates communication with the patient regarding patient financial responsibility.

5. Documents coordination of benefits and plans of care in pharmacy applications, and communicates to stakeholders as needed to ensure optimal medication therapy. Partner with others to handle and resolve escalated issues when appropriate and act urgently when necessary.

6. 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.

7. Attends to