Remote Pbm Jobs in Minnesota (NOW HIRING)

Description

ABOUT VISANTE
We are relentless in solving the most complex challenges in health system pharmacy-designing pharmacy footprints that meet our clients where they are today and position them to win tomorrow. Our work delivers measurable financial gains, operational excellence, and an elevated patient experience.

We set ambitious goals, move with urgency, and create extraordinary value. Obsessed with client impact, we thrive in a collaborative, innovative culture where deep expertise turns insight into action. We're proud of the results we deliver and the trust we earn-fueling sustained growth and exceptional client satisfaction.

Our mission is to transform healthcare through pharmacy, and our vision is to reimagine pharmacy to improve lives.

ABOUT THE ROLE (Remote, work from home)

The Medication Access Specialist plays a vital role in Visante's managed services team, providing integrated remote support to patients, pharmacists, and providers. Responsibilities for this position include streamlining patient intake processes, navigating insurance requirements, enhancing medication access, conducting patient outreach, and reducing the financial burden of high cost prescriptions. Acting as a liaison among pharmacies, clinic staff, and insurance providers, the specialist optimizes treatment initiation and improves patient satisfaction by conducting benefits investigations, handling medication authorizations, managing insurance denials, and identifying assistance programs. The specialist communicates medication options and financial resources to patients while monitoring insurance status and reporting access issues to the treatment team. Emphasizing collaboration and efficiency, this position contributes to Visante's mission of ensuring patients receive the medications they need and improving patient outcomes 

Principal Duties and Responsibilities  

• Lead the medication intake process, serving as a liaison among clinic providers, clinic staff, pharmacies, and patients.
• Conduct benefits investigations to determine patient coverage, out-of-pocket costs, and available financial assistance.
• Identify and recommend patient assistance programs, copay cards, grants, or funds to reduce financial burdens.
• Gather and review necessary documentation for prior authorization submissions, escalating appeals for coverage denials.
• Coordinate next steps for insurance denials to clinic staff for review and decision-making regarding appeals process. 
• Communicate directly with clinics to obtain additional information and guidance related to prior authorization submission.
• Conduct patient outreach to discuss medication coverage and financial assistance options, providing pharmacy recommendations. 
• Communicate coverage determinations and coordinate follow up with patients on behalf of   the client clinic.  
• Ensure timely and accurate documentation in client EMR systems and Visante tracking tools for workflow efficiency. 
• Assist with onboarding and training of client-employed medication access specialists and contribute to process improvements.
• Collaborate with Visante team members and leadership to provide insight and constructive feedback into day-to-day operations.
• Complete other duties as assigned. 

Requirements

Education

Required: High school diploma or equivalent

Experience

Required: Minimum of three years of pharmacy experience in healthcare or with pharmacy providers focused on medication access 

Preferred: Two years of healthcare revenue cycle experience, including medication authorizations and preadmission/precertification processes. Expertise in retail pharmacy PBM adjudication, ensuring accurate claim processing and reimbursement. Proficient in utilizing CoverMyMeds for prior authorization submissions, streamlining medication access. 

Licensure

Required: State Board of Pharmacy Technician registration obtained within 2 months of start date, if applicable based on state requirements  

Preferred: Active CPhT certification through either PTCB or NHA 

Skills and Abilities  

• Demonstrate strong judgment and decision-making, effectively managing competing demands while prioritizing tasks and meeting deadlines with urgency.
• Cultivates strong client relationships, exhibiting excellent interpersonal and team collaboration skills while communicating professionally and concisely in both verbal and written forms.
• Possesses extensive expertise in medication reimbursement, prior authorization, and healthcare coding, utilizing analytical and creative problem-solving abilities to diagnose and resolve issues.
• Maintains confidentiality and ensures accuracy, leveraging proficiency in Office Suite (Word, Excel, PowerPoint) to analyze and disseminate critical information effectively.

Compensation and Benefits:  We offer competitive salary and benefits for this full-time salaried, non-exempt role. 

Equal Opportunity Statement: Visante is an equal opportunity employer. Visante's people are its greatest asset and provide the resources that have made the company what it is today. Visante is, therefore, committed to maintaining an environment free of discrimination, harassment, and violence. This means there can be no deference because of age, religion or creed, gender, gender identity or expression, race, color, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by applicable laws and regulations