Offer summary

Qualifications:

State registered or certified pharmacy technician required., 1+ years of experience as a Pharmacy Technician., High school diploma or GED required., National certification as a CPhT or equivalent preferred..

Key responsibilities:

Communicate with insurance companies to facilitate medication approvals.

Navigate pharmacy systems to input data and manage claims.

Assist patients with pharmacy insurance claims and medication compliance.

Maintain accurate records of patient communications and assist in process improvement initiatives.

Job description

At Shields Health Solutions, we pride ourselves on our culture of inclusion, kindness, acceptance, and the difference we make in patients' lives every day. We are tremendously proud to consistently be certified as a ‘Great Place to Work’ several years in a row; we’ve been recognized as a Fortunes Best Workplaces in Healthcare™, Millennials™, and Women™; and a Becker’s Healthcare Top 150 Workplace.

Patients are at the heart of everything we do. We are committed to improving lives by ensuring seamless access to specialty medications, better health outcomes, and an enhanced care experience. That’s why more health system leaders trust us to deliver personalized support and comprehensive solutions that make specialty pharmacy more accessible for the patients who need it most. Through our proven Shields Performance Platform, we help drive the financial sustainability of health systems while prioritizing best-in-class outcomes that patients deserve. With a team of leaders in specialty pharmacy, a track record of success partnering with over 80 health systems, and an unwavering dedication to measurable results, we empower health systems to transform their specialty pharmacy into a driver of growth—ensuring every patient receives the best possible care.

Patient Support Advocate

Job Purpose:

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.

Job Duties:

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.
Identify trends, resolve problems; recommend improvements; implement change.
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.

Experience/ Education:

Required Licensure/Certification: We are seeking experienced pharmacy technicians who are state registered, or state certified as a pharmacy technician. Nationally certified as a CPhT or equivalent is strongly preferred but not required.

*If the candidate's state of residence does not have a state registration available, then the National certification is required at time of hire. Should additional licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements.

Years of Experience: Required 1+ years as a Pharmacy Technician

Education: High school diploma or GED required

California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Required profile