Ambulatory Liaison - Brown University Health
Providence, RI
About the Job
accessible and reliable pharmacy services for patients. Interacts effectively and compassionately with patients and families. Acts as an agent of the provider to authorize refills in accordance with established practices policies and guidelines. Interacts effectively and professionally with other health care providers at all levels including but not limited to providers nurses and support personnel. Utilizes the patient�s electronic health record (EHR) to obtain accurate and necessary patient information needed to process prescriptions and payment transactions. Accesses inputs and retrieves information using multiple pharmacy system applications.
Responsibilities:
Exhibits a friendly pleasant and helpful nature demonstrating a strong customer service orientation when interacting with patients their families providers nurses and support personnel. Maintains and supports pharmacy interdepartmental relationships to ensure seamless transition of patient care from clinic to pharmacy.
Protects and maintains patient confidentiality in accordance with Health Insurance Portability and Accountability Act (HIPAA) guidelines. Collects customer/patient personal information necessary for filling prescriptions benefits investigation prior authorization and/or financial assistance applications. Enters pertinent patient data into appropriate organizational systems to ensure accurate charging for services and processing of insurance billing payments and co-pay information.
Participates in the growth of the Brown University Health Pharmacy (LP) patient population through recruitment of ambulatory care patients. Responds to questions relative to cost and availability of medication and pharmaceutical supplies. Informs customers/patients providers and support personnel of wait times and any issues regarding drug availability including advising on the refill authorization process for expired prescription orders.
Encourages patient retention through the development of individual relationships with assigned patients. Proactively contacts patients via phone in-person or other supervisor approved modality to assess patient need for medication including estimations of patient adherence such as medication supply on hand. Assists patients/customers in resolving identified problems. Proactively identifies patients with clinical needs such as questions concerning medications and drug interactions and refers such patients to a pharmacist.
Participates in quality assessment and improvement activities. Assists in identifying improvement opportunities and in the development of new processes. Participates in medication safety initiatives related to LP and uses approved processes for reporting actual prevented and near miss medication errors.
Under the guidance of a pharmacist and direction of a Technician Supervisor or Group Leader assists in training onboarding and supporting fellow staff.
Prior Authorization and Financial Assistance Services:
Conducts a benefits investigation for patients identifies coverage details that the patient or patient�s representative is unable to provide. Navigates the EHR to effectively answer questions and provide documentation as needed for prior authorizations and/or financial assistance application. Performs prior authorizations appeals and tier exceptions as necessary on provider�s behalf and relays results to patients families providers and pharmacies as appropriate.
Secures treatment related financial assistance for patients whenever possible including but not limited to manufacturer assistance programs discount programs and nationally recognized foundations. Refers patients to medication manufacturer assistance programs and assists with application to said programs when applicable. Coordinates submission of financial assistance application between patient clinic and providers to ensure all paperwork is submitted appropriately for qualifying patients.
Prescription Refill Services as an Agent of a Provider:
Acting as the agent of a provider who is a licensed clinician employed or under contract with a Brown University Health affiliated entity and has agreed in writing to participate (Opt-in) in the Brown University Health Medication Access Program (MAP) hereinafter referred to asProvider the Ambulatory Liaison authorizes prescription refills in accordance with the document entitled �Brown University Health Medication Access Refill Guideline�.
Acting as the agent of a Provider communicates to Provider�s patients or their pharmacy the Provider�s approval of refills permitted under the Brown University Health MAP.
Using the MAP and the conditions set forth in the �Brown University Health Medication Access Refill Standards� approves prescription refills under certain conditions while requiring further consultation with the prescribing clinician or the assistance of the pharmacist for other requested refills.
Consults the EHR MAP and Brown University Health Medication Access Refill Standards prior to authorizing any refill requests.
Confirms that the patient�s Provider has signed a MAP Prescriber Brown University Health Medication Access Refill - Prescriber Opt-in form giving Ambulatory Liaison�s approval in advance to authorize prescription refills.
Approves the prescription refill request if the patient has seen the provider within the specified amount of time laboratory testing is up to date and requested medication is on both the medication list in the EHR and the Brown University Health Medication Access Refill Standards.
Reroutes requests to provider clinical staff office staff or pharmacist when defined criteria in �Brown University Health Medication Access Refill Standards� are not met.
Refuses refill requests as per the �Brown University Health Medication Access Refill Guidelines�.
Assists providers in identifying ancillary supplies necessary for select medications including but not limited to sharps containers needles/syringes alcohol swabs and bandages.
Other information:
BASIC KNOWLEDGE:
Prior Authorization and Financial Assistance Services:
High school graduate or equivalent degree required. Completion of one to two years of college preferred.
Maintains current unrestricted Rhode Island Pharmacy Technician II license.
Holds and maintains current National Pharmacy Technician Certification (CPhT).
Prescription Refill Services as an agent of a Provider:
High school graduate or equivalent degree required. Completion of one to two years of college preferred.
Holds and maintains current National Pharmacy Technician Certification (CPhT).
EXPERIENCE:
Minimum one year experience as a pharmacy technician. Commensurate experience in a related field (e.g. benefits management) may be considered in lieu of technician experience. Prior experience with specialty pharmacy services call center customer service prior authorization management and/or patient financial assistance programs strongly preferred.
Strong customer service presence and verbal and written communication skills necessary to effectively interact with patients providers nurses and ancillary support staff required.
Ability to multi-task and reprioritize as needed while maintaining accuracy and service standards.
Must obtain within 3 months of hire and maintain no less than annually thereafter pharmacy ambulatory liaison competency requirements as demonstrated through completion of the Medication Access Program Competency Checklist as well as disease state-specific training accreditation updates and other operational competencies as required.
WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:
Extended periods of time spent sitting.
Work requires the visual acuity and manual dexterity necessary to operate a computer and input data using a typical keyboard and computer mouse to navigate multiple computer monitors.
INDEPENDENT ACTION:
Performs independently within department policies and procedures.
Refers specific complex problems to supervisor where clarification of departmental policies and procedures may be required.
SUPERVISORY RESPONSIBILITY:
None.
Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.
Location: The Miriam Hospital USA:RI:Providence
Work Type: Full Time
Shift: Shift 4
Union: Non-Union
