Specialty Pharmacy Patient Liaison - Prior Authorization

URAC – Drug Testing Required

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 essential to the growth and sustainability of the specialty pharmacy business and plays a central role in supporting the health system’s operating margin. 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. The Pharmacy Patient Liaison is responsible for providing technician pharmacy services with an emphasis on performing assigned tasks that require working independently and increased competency relating to patient medication therapy.

Position: Prior Authorization Liaison - Specialty Pharmacy

Department: Specialty Pharmacy

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Pharmacy Patient Liaison Responsibilities

• Navigate Electronic Medical Records (EMR) and manage documentation, prior authorizations, and financial assistance processes accurately and efficiently

• Communicate effectively across clinical and administrative teams and with patients to support hospital initiatives, medication access, and patient care

• Exercise sound judgment to resolve complex patient care issues and escalate appropriately to ensure safety and quality

• Manage workload independently in a fast-paced environment while demonstrating strong technical proficiency and problem-solving skills

• Train, mentor, and support new staff to uphold operational standards and maintain high-quality service delivery

• Document and triage patient interactions and pharmacy-related concerns to ensure safe, coordinated care and medication adherence

• Foster trusting relationships with providers, care teams, ancillary staff, and patients to enhance collaboration, transitions of care, and patient retention

Prior Authorization Responsibilities

• Assess and extract clinical documentation to meet payer criteria for drug approvals

• Cultivate payer relationships and stay current on payer requirements within assigned areas to optimize patient outcomes and maximize medication access

• Proactively identify barriers to medication access and develop solutions to improve patient adherence

• Evaluate, monitor, and pursue financial assistance opportunities to reduce patient out-of-pocket costs

• Manage financial assistance applications and support processes throughout the patient’s medication journey

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

REQUIRED EDUCATION AND EXPERIENCE:

• Requires a high school diploma (or state accepted equivalency)

• Must have a minimum of 4 years of pharmacy experience

• Pharmacy Interns must be in their 2nd year

• As part of the employment screening process, to be compliant with URAC requirements, employees hired into this role must pass a drug screen.

PREFERRED EDUCATION AND EXPERIENCE:

• AA or BA

• Knowledge of transplant, hepatitis C, infectious diseases (including HIV), oncology and/or other specialty medication therapies

• Bilingual or multi-lingual skills (beyond that of English) appropriate to the patient population served

• 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

CERTIFICATIONS, LICENSES, REGISTRATIONS REQUIRED:

Must be currently registered as a Pharmacy Technician or Pharmacy Intern with the Board of Pharmacy in Massachusetts.

Must have/maintain national technician certification through PTCB or exCPT.

KNOWLEDGE, SKILLS & ABILITIES (KSAs):

• 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.

Compensation Range:

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.

NOTE : This range is based on Boston-area data, and is subject to modification based on geographic location.

Equal Opportunity Employer/Disabled/Veterans

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