Patient Care Coord.- Specialty Pharmacy, King of Prussia

Today, Jefferson Health and its network of hospitals and physician practices serve patients throughout the Delaware Valley. We have a robust network of 18 hospitals, 3500 physicians, 9600 nurses, 3,876 licensed beds, and physician practices throughout the counties of:

• Bucks
• Camden
• Gloucester
• Montgomery
• Philadelphia

We are Philadelphia's second largest employer, and nationally ranked by US News & World Report in seven specialties including #2 Ophthalmology (Wills Eye), #9 Rehabilitation (MossRehab), #10 in Orthopedics (Rothman Orthopaedics at Jefferson Health, Philadelphia Hand to Shoulder Center, 3B Orthopedics, the Abington Orthopedic & Spine). Whether you're in the city or the suburbs, Jefferson Health provides the exceptional care you expect - close to home or work - through our broad family of primary care physicians and specialists. Jefferson Health is home to nationally ranked experts who provide a personalized care plan for you. Sidney Kimmel Cancer Center - Jefferson Health is one of only 70 NCI-designated cancer centers in the country. With more than 30,000 employees, we are the largest health system in the Philadelphia region by total licensed beds. And our work to improve lives is never done.

In keeping with Jefferson's Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. If you are enthusiastic, caring and dedicated to service excellence, we invite you to consider joining Jefferson. Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education.

Department Marketing Statement

Culture

We are a creative and collaborative team dedicated to outstanding professional work on behalf of our patients. Our goal is to meet our patients' needs and help them advocate for themselves and their family members. We believe our place in the community is as a healer, an activist, and a trusted friend. We perform our duties with empathy and compassion as we serve the needs of the underserved population of North Philadelphia. While we do have an academic component to our work, we strive to be community doctors who take pride in serving others. Join us...make a difference.

Responsibilities

This positoin is located in our Specialty Pharmacy office: 3500 Horizon Dr King of Prussia, PA 19406

Job Summary

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.

Essential Functions

Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

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

Qualifications

Competencies (Knowledge, Skills, and Abilities Required):

Competency

Description

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

Minimum Education and Experience Requirements:

¿¿Education:¿

High School Diploma or GED equivalent preferred

AND

¿¿Experience:¿

3+ years experience in customer service role

1+ years experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment.

Manager - Please indicate minimum level of education and experience for this job. Please indicate whether it is required or preferred.

Additional Information

• 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

Closing Statement

About Jefferson

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.

Par Reference Code

112061