Medication Refill & Prior Authorization Specialist (17174)

Northern Light Health
Job Description

Northern Light Pharmacy

Department: Pharmacy - Refill-Authorization Program

Position is located: Cianchette Professional Building, Brewer, ME

Work Type: Full Time \ 40 Hours per Week \ 8:00 AM to 4:30 PM

To Apply Click: Medication Refill & Prior Authorization Specialist

For More Information: Text "17174" to (207) 506-0033

Sign on bonus: This position is eligible for a $500 sign on bonus.

*Current employees of any Northern Light Member Organizations or those with a service break less than one year are not eligible.

Summary:

Northern Light Pharmacy provides convenient and compassionate pharmacy services to support and improve the health of our community.

This is an entry level position. The Medication Refill & Prior Authorization Specialist is an essential member of the staff at Northern Light Pharmacy and Northern Light Health System. This position will assist with all aspects of the medication refill and prior authorization process for Northern Light Health practice patients . This role will communicate and work effectively with patients and various members of the healthcare team including clinical support staff and providers. Medication Refill & Prior Authorization Specialist also provide support for multiple facets of the operations of the Pharmacy, including exceptional customer service and answering the phone in a timely manner.

Responsibilities:

  • Under the supervision of the Manager of Clinical Pharmacy services and/or Technician Supervisor , and in conjunction with outpatient practice leadership the medication refill specialist assists with all aspects of the medication refill process using established guidelines to facilitate authorization of medication refills for clinic patients. This role will communicate and work effectively with patients and various members of the healthcare team including clinical support staff and providers.

    •Receives prescription refill requests by fax, e-prescribe or phone

    •Authorizes prescription refills according to protocol using the Electronic Medical Record (EMR)

    •Completes all aspects of prior authorization requests

    •Effectively and appropriately responds to patients, pharmacies, pharmacists and clinic staff

    •Utilizes the electronic health record to ensure patients are in compliance with laboratory monitoring for medications based on protocols and communicate gaps in monitoring to the care team

    •Completes refill requests in a timely and accurate manner according to protocols

    •Communicates decisions to physicians, physician’s office staff, patients and/or pharmacists

    •Escalates requests to prescriber and/or office staff when request requires extensive clinical review or denial

    •Coordinates scheduling of visits and labs as directed by protocol, provider or the pharmacist

    •Triages phone calls from pharmacies, patients and providers

    •Troubleshoots patients and providers questions and concerns

    •Provides high quality customer service to patients, family members and care team members

Competencies and skills:

Essential:
* Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
* Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation.
* Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively.
* Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit.
* Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
* Exercises Sound Judgment & Decision Making: Understands and processes complex information, which allows for appropriate and accountable conclusions. Does not react too quickly or slowly. Balances facts, goals, and potential approaches taking the appropriate criteria into account. Makes active decisions and commits oneself by communicating confidently and respectfully.
* Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
* Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.
* Serves Others: Strives to understand, meet and exceed the expectations and requirements of internal and external customers which may include the people and communities in our service areas. Develops and maintains relationships, alliances and coalitions within and outside the organization and leverages them in order to obtain information, support, and promote cooperation and collaboration.

Education:

Essential:
* High School Diploma/General Educational Development (GED)

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