As the first and largest specialty pharmacy integrator and accelerator, Shields Health Solutions sits at the nexus of the $200B specialty pharmacy industry. Shields builds and manages hospital-owned specialty pharmacies for health systems who want to offer coordinated care services for patients with chronic illness. Our patient-centric TelemetryRx platform enables health systems to improve medication adherence, reduce patient readmission rates, and ultimately improve health outcomes through the collection and distillation of clinical, behavioral, and financial data. Shields Health Solutions is one of the fastest growing healthcare companies and has proven its immense impact on patients' lives.
What you will do:
The Company is seeking a highly motivated, self-starter who is looking for a challenging career with a fast-growing company in the specialty pharmacy management services. Critical to this position is a person who is able to establish strong and credible relationships with patients, clinicians, and internal Shields staff. Applicants should be results-oriented with a positive outlook and a clear focus on high patient quality and service. A natural forward-planner who critically assesses own performance. Mature, well-presented, professional and comfortable in dealing with others both in-person and on the phone. Applicant must be reliable, tolerant, and determined; an empathic communicator, able to see things from the other person's point of view. Most importantly, this person must be able to work as a member of a close-knit team.
Within this role, this person will provide patient care by removing the barriers to medication access. Working with insurance companies and clinician offices to facilitate approval of medications through prior authorizations. Working with patients and a variety of funding sources such as foundations, or directly through manufactures to obtain financial assistance for high dollar co-pays. Provide phone support to patients by navigating a variety of pharmacy dispensing systems to adjudicate claims, refill medications, and increase adherence in patients.
Details on the role:
Directly communicate with insurance companies to facilitate the approval of medications
Navigate pharmacy operating systems to input data, perform adjudication on test claims and prepare action plans for follow-up
Effectively communicate across databases, electronic medical records and emails to document patient concerns, prior authorization status, and financial assistance needs.
Review prescriptions with doctors' offices to ensure optimal care of the patient
Keep complete and accurate records of patient communications
Assist patients in the management of their pharmacy insurance claims
Work closely with pharmacists and pharmacy liaisons to provide an integrated approach quality patient care
Communicate directly with patients over the phone to assist them in all aspects of medication compliance
Research and investigate information to enable strategic decision-making by others
Manage, organize, and update relevant data using database applications
Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards
Actively participate in process improvement initiatives
Act as a value-added business partner to stakeholders throughout the organization
Protect organization's value by keeping information confidential
Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
Minimal in or out of state travel may be required
Perform other duties as assigned
What you need:
We are seeking experienced pharmacy technicians. It is preferred that technicians are licensed prior to hiring, if not licensed prior to hiring then one must obtain license within 6 months of their hire date.
It is preferred that technicians are certified prior to hire, if not certified prior to hire then obtained within an agreed amount of time.
Continued employment is contingent upon meeting these requirements.
Up to 1 or more years of experience as a Pharmacy Technician is preferred
We are looking for someone with strong phone skills
Highly proficient in Microsoft Office particularly Excel and Word.
Ability to quickly learn other database programs (knowledge of the Willow, Qs1, and RX30 software system a plus) and able to identify relevant information with a focus on quality.
The applicant should be very organized with attention to detail and have great interpersonal skills, high integrity, be dependable and a good listener and an empathetic communicator.
The ideal candidate will be an energetic and highly motivated, team player with a willingness to do whatever is necessary for the betterment of the company.
High school diploma or GED
Discretion and confidentiality are essential as position deals with highly sensitive and private data.
Internal Number: 94679
About Shields Health Solutions
One of the fastest growing companies in America, Shields Health Solutions partners with hospital leaders on every aspect of specialty pharmacy creation and management. The company provides the fastest, lowest risk model for Hospital leaders to create a hospital-owned specialty pharmacy business, whether starting from scratch or adding specialty capabilities to a hospital's existing pharmacy programs.