About the role
Description
Are you seeking a career with a growing company, a place where you can make an impact in the community? Then Positive Impact Health Centers is the company for you.
Positive Impact Health Centers (PIHC)
is a community leader in providing HIV prevention, care and treatment services located in Metro Atlanta. The PIHC model of care assures that clients have access to medical, pharmacy, dental, behavioral health and social services, providing the best opportunity for patients to achieve high-quality health outcomes. Services are provided on-site and through telehealth.
What makes us different? We offer our employees the following:
Health Wellness day per quarter
Parental Leave
Free parking at our locations/bus line accessibility
Competitive Salary & Benefits
Automatic 3% Safe Harbor & 2% Profit Sharing (Retirement Program)
100% allotted for benefit elections for employees, 50% allotted for benefit elections for employee's spouse/dependent
Credit Union
JOB SUMMARY:
Under supervision of Pharmacist in Charge, serves as the primary point of contact for PIHC Pharmacy for the assigned PIHC Clinic Team. Provides outstanding customer service and professional communication skills for both external and internal relations regarding patient access to medication services including, but not limited to: benefits investigation, prior authorization, appeals, copay assistance, refills, and all other aspects of the Patient Medication Journey.
This position description should not be interpreted as all inclusive. It is intended to identify the major responsibilities and requirements of this position. The incumbents may be requested to perform job-related responsibilities and tasks other than those stated in this position description.
Requirements
ESSENTIAL FUNCTIONS:
Duties and Responsibilities
Serve as PIHC Pharmacy liaison to assigned PIHC Clinic team to field questions related to patient medication access from patient, provider, or others involved in patient’s medication access, establish self as primary internal and external liaison and subject matter expert for medication assistance through educational trainings
Screen, apply and coordinate application of medication assistance opportunities for patients
Enroll and coordinate necessary paperwork for manufacturer assistance programs, disease- based assistance programs, identifying co-pay assistance opportunities for underinsured patients and use of charity funds as appropriate, following PIHC
Pharmacy’s Policies and Procedures
Assists patient and prescribers with the Prior Authorization process
Coordinates billing and obtains cost approval
Troubleshoot rejected claims and eligibility investigation, thoroughly investigate status of claims, and works with processors on billing issues or retroactive billing as need, and ensure expedite claims processing
Proactively identify problematic third-party payor scenarios to minimize billing rejections, report trends or issues related to billing and reimbursement
Support agency wide efforts to ensure access to prescription medications
Coordinate documentation to promote continuity of treatments, improve access to medications, decrease financial strain and serve as a resource for medication assistance-related questions
Support medication compliance program by contacting patients when needed and confirming refills needed as well as ensuring patient information is up-to-date and accurate
Contribute to policy changes, goal setting or making recommendations for improvements
Attend and conduct meetings as deemed appropriate by pharmacy management
Provides quality customer service to patients and other healthcare providers, with focus on professional discretion and HIPAA regulations
Performs all tasks in a safe manner that is consistent with corporate policies as well as state and federal laws
May be assigned additional process or quality improvement projects based on departmental need.
Knowledge, Skills, and Abilities
Ability to function independently without close supervision when appropriate
Able to adapt to change in workflow/ style
Proficient computer skills, word processing, documentation, and navigation of the internet
Excellent time management and research skills
Ability to problem solve and communicate effectively
Knowledge of Patient Assistance Programs (PAPs) and ability to navigate alternative sources of funding
High level of dedication to patient care and improving patient medication access
Clear understanding of and the ability to comply with the GA BOP Rules and Regulations
High level of attention to detail
Comfortable with addressing insurance rejections and prescription claims processing
Self-motivation and driven to succeed
Minimum Qualifications
Licensed pharmacy technician in good standing with the Georgia Board of Pharmacy
2-4 years of pharmacy technician experience in a retail setting with experience with pharmacy insurance navigation and various medication assistance programs
Preferred Qualifications or Experience:
Bilingual (English/Spanish) Preferred
Experience working in HIV and/or Specialty Pharmacy
Experience working in a 340B Pharmacy and/or 340B Contract Pharmacy
Previous experience with Cerner EMR
Past experience with Pioneer Rx Fill Software
License/Licensure:
Licensed pharmacy technician in good standing with the Georgia Board of Pharmacy
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to sit and talk or hear. The employee is occasionally required to walk, use hands to finger, handle, or operate computers, objects, tools, or controls and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.