Number of Positions In Requisition
1


Job Details
Specialty Pharmacy Patient Care Navigators handle a broad variety of interactions with clients, providers, payers and manufacturers critical to the services provided by the Specialty Pharmacy. The core functions include handling incoming and outgoing client and patient interactions and follow thru and resolution of customer inquiries. Interactions include calls from patients, families, provider offices, payers, and manufacturers. Handles other miscellaneous tasks, including the reconciliation of delivery tickets, and investigating expired prescriptions and encounters. Handle every interaction with the utmost service and resolve; providing a patient/client experience that supports our commitment to efficient and effective connections to care. Interact with a diverse patient base to ascertain the reason for the interaction and assist the client with their inquiry, concerns or problems with a focus on first call resolution. Demonstrate commitment to service and follow-through. Follow departmental protocols to ensure patient safety and accurate data entry.
Job Description
SummarySpecialty Pharmacy Patient Care Navigators handle a broad variety of interactions with clients, providers, payers and manufacturers critical to the services provided by the Specialty Pharmacy. The core functions include handling incoming and outgoing client and patient interactions and follow thru and resolution of customer inquiries. Interactions include calls from patients, families, provider offices, payers, and manufacturers. Handles other miscellaneous tasks, including the reconciliation of delivery tickets, and investigating expired prescriptions and encounters. Handle every interaction with the utmost service and resolve; providing a patient/client experience that supports our commitment to efficient and effective connections to care. Interact with a diverse patient base to ascertain the reason for the interaction and assist the client with their inquiry, concerns or problems with a focus on first call resolution. Demonstrate commitment to service and follow-through. Follow departmental protocols to ensure patient safety and accurate data entry.
Job Duties- Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.(Do not delete, move or over-write this statement)
- Receive, Handle, and Triage calls/interactions accordingly based on client’s needs including but not limited to: Assessing refill needs, scheduling delivery of medications, copay collections, package & delivery tracking, obtaining payer/copay card information, status updates of orders, receiving/relaying information to the client
- Practice First Call Resolution by identifying and assessing client needs to work towards a satisfactory solution
- Assess for clinical escalation to pharmacist where appropriate
- Accurately research and document all interactions within the Electronic Medical Record (EMR) per departmental policy and guidance
- Access EMR and other software to answer, coordinate, track, and monitor interactions across multiple channels of communication. Maintain qualitative and quantitative individual and team performance targets.
- Identify issues and communicate solutions to customers, pharmacies, physicians, and payers regarding scheduling and delivery information, prescription order status, eligibility, and claims information
- Effectively collaborate with internal departments and external entities to resolve customer issues, including billing, logistics, insurance coverage, and manufacturer copay card programs
- Additional administrative and pharmacy tasks and duties may be assigned by management
Minimum Qualifications- 3 years experience in customer service role and
- 1 year experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment.
- Maintain knowledge of and comply with regulatory guidelines set forth by the State Board of Pharmacy, FDA, DEA, DHS, Medicare, TJC, and URAC as applicable to functional role
- Demonstrated ability to listen skillfully, accurately collect & document relevant information, and build relationships and trust with
- Knowledge of and ability to utilize practices, tools, and techniques for communicating with a client
- Knowledge of the major responsibilities, accountabilities, and overall organization of the client support function or department, ability to properly support client inquiries and bring problems to a timely resolution.
- Independently resolves complex client conflicts including but not limited to: damaged/lost products, order placement, and outstanding balances and invoices
- Multi-task between several issues at one time
Preferred QualificationsAdditional Qualifications- Proficient in the use of computers and Microsoft applications. Type 35 wpm.
- Experience with clinical software systems; Specialty Medications and Medicare billing is highly preferred.
- Ability to communicate professionally and efficiently in both written and verbal format with patients, physicians, payors and clinical staff in-person and on the phone.
- Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc.
- Detailed orientated with excellent organization skills, ability to learn quickly, solve problems and make informed educated decisions.
- Ability to adapt in a dynamic work environment
- Demonstrated ability to handle difficult conversations in a professional and caring manner
Physical DemandsLift and carry 40-50 lbs. Examples: Push/pull patients on bed, stretcher (requires 29 lbs. push force), lateral transfers up to 50 lbs. of the patient's weight. Frequent to continuous standing/walking. Patient transporters can walk 8-10 miles per shift. *Patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Thomas Jefferson University Hospitals, Inc.
Primary Location Address
3500 Horizon Drive, King of Prussia, Pennsylvania, United States of America
Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
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