Prior Authorization Support Liaison- Specialty Pharmacy - Boston Medical Center

POSITION SUMMARY:

Boston Medical Center (BMC) provides a specialty pharmacy service to serve the complex medication needs of its chronic patients. BMC Specialty Pharmacy will provide patients who require specialty drugs a comprehensive service program that includes an on-site pharmacy staffed with a care team that includes: Pharmacists, Pharmacy Technicians and Pharmacy Liaisons. The cornerstone of BMC's Specialty Pharmacy approach is an unparalleled level of integration with the clinical team coupled with highly personalized service, thus driving better outcomes at lower cost.

The Pharmacy Patient Liaison is a unique role that provides integrated support to patients and pharmacists by providing a 'hands-on' approach to total quality patient care. This position is considered essential to the growth and maintenance of the specialty pharmacy business line and is considered at the core of supporting health system operating margin. Management of specialty patients and their drugs is done in a manner that is similar to management of sales accounts. This hybridized role is a unique combination of patient service delivery and business performance.

The Pharmacy Patient Liaison works closely with patients to deliver a full continuum of medication adherence support by utilizing BMC's various tools and applications. Encourages patients of clinics to utilize BMC pharmacy to fully benefit from its superior patient care services. Given that the Pharmacy Patient Liaison may be located in a clinical area, seamlessly integrating with the clinic team (doctors, nurses, staff, etc.) is critical to the liaison's success.

Position: Prior Authorization Support Liaison

Department: Specialty Pharmacy

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Patient Relationship Development and Client Sales - Responsible for managing and growing patient account base by recruitment and retention of specialty pharmacy services driven through BMC Health System
  • Sales and recruitment functions
    • Patient Liaisons are assigned specific responsibilities in which they are given target goals and expectations in recruitment of patients into the specialty program at BMC
    • Such target goals are measured and evaluated on a consistent basis through various sales and reporting customer relationship platforms, and through revenue performance of each individual specialty service line
    • Recruitment functions may include following up on provided leads for new business in clinic, and generating leads through provider relationships or direct customer service engagements
  • Patient Retention
    • Encourages patients of clinics to utilize BMC pharmacy to fully benefit from its superior patient care services
    • Work closely with patients to deliver a full continuum of medication adherence support by utilizing our various tools and applications
    • Provide outbound therapy/medication adherence check-ups by process refills to ensure no gaps in refills/treatment
    • Build relationships with patients by providing friendly, courteous and efficient service
    • Retention of patient business is essential for growth and thus is measured as closely as the sales and recruitment functions of patient liaisons

• Personnel Responsibilities - Responsible for building and maintaining relationships with provider, care teams, and ancillary support necessary to sustain sales and recruitment functions
  • Internal Relationships
    • Developing and growing trusting relationships with providers and hospital staff to provide highest level of care for a complex patient panel
    • Maintaining and supporting pharmacy interdepartmental relationships and management to ensure seamless transition of patient care from clinic to pharmacy
  • External Relationships
    • Developing and growing trusting relationships with patients to provide highest level of care

• Operational Responsibilities - Technical savvy, communicating at all levels of the hospital organization and problem solving are required
  • Navigate patient Electronic Medical Record (EMR) to effectively answer questions and/or provide documentation as needed for prior authorizations
  • Communicate with providers (Doctors, Nurses, Clinical Pharmacists) in person, over the phone, and through written transmission via EMR in a timely and professional manner
  • Communicate with Specialty Pharmacy Management, Medical Directors, and Practice Managers to provide support for new and ongoing hospital initiatives
  • Resolve high level patient care issues and situational awareness around when to involve managers and/ or clinicians
  • Demonstrate resourcefulness in the face of challenges and providing workable solutions to complex problems
  • Capacity to work independently by managing workload and meeting established goals in a fast paced environment
  • Train and support new staff in understanding and learning the expectations for day-to-day operations in a specific role

Must adhere to all of BMC's RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

• HS Diploma or G.E.D. required
• AA or BA preferred

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• Must be currently registered as a Pharmacy Technician or Pharmacy Intern with the Board of Pharmacy in Massachusetts.
• Technicians must have current active National Certification verified by PTCB or ExCPT or obtained within 6 months of hire.

EXPERIENCE:

• Must have 4-5 years' of pharmacy experience
• Pharmacy Interns - must be in their 2nd year

KNOWLEDGE AND SKILLS:

• Excellent English oral and written communication skills required; as well as ability to communicate professionally over the phone.
• Excellent interpersonal skills to provide superb personalized customer service and to instill confidence and to advocate for patients; ability to explain required information to customers in a comprehensible manner.
• Other professional skills and qualities: organized, strong attention to detail, ability to self-direct through multitasking and prioritizing, dependable, empathetic, focused on quality service, goal oriented.
• Cultural sensitivity, understanding, and comfort with a wide range of social, racial and ethnic populations.
• Must practice discretion and confidentiality as position deals with highly sensitive and private data.
• Ability to understand, explain, and actively promote the hospital's objectives through direct coordination and commitment to the program's goals.
• Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc.
• Highly proficient in Microsoft Office particularly Excel, Word, and Outlook. Ability to quickly learn other relevant applications that support management of patient care and assigned responsibilities; and ability to extract necessary information.

Additional preferred qualifications:

• Knowledge of transplant, hepatitis C, infectious diseases (including HIV), oncology and/or other specialty medication therapies preferred.
• Bilingual or multi-lingual skills (beyond that of English) appropriate to the patient population served is a plus.
• Experience with submission of prior authorization requests to third party payors
• Familiarity with 340B drug program and ACO hospital models.
• Knowledge of QS1/NRx, EPIC, Salesforce, Navinet

Req id: 28175