Remote Prior Authorization Jobs in Florida (NOW HIRING)

The Specialty Pharmacist Navigator seeks relationships with physicians and physician practices who use specialty pharmaceuticals for the purpose of prescribing the medications, training, and assisting patients.

Location: This hybrid role is largely remote and is intended for an Rph in the Orlando, Fl or Daytona Beach, FL area, as well as the surrounding areas.

Responsibilities:

• Access various physician practices for potential specialty Rx value using tools/data available.

• Establish communication with targeted specialty practices, arranging meetings with key stakeholders/decision makers.

• Demonstrate value of ambulatory pharmacy partnership to specialty practices.

• Ensure prescriptions flow through to ambulatory pharmacy and are identified by pharmacy staff.

• Establish patient profiles, including third-party payor(s) and clinical information.

• Process prescriptions, including insurance adjudication and product sourcing.

• Prepare and submit prior authorization paperwork; manage denials.

• Triage prescriptions which are limited distribution drugs or out-of-network.

• Act as financial advocate for patient where needed; leverage charitable foundations, state programs, and/or manufacturer programs to ensure maximal patient access

• Coordinate pickup/courier delivery of Rx's with patient.

• Follow up with patient to ensure refills are ordered on time and address and ADR's or clinical questions.

• Inform physician office of patient through process; document in EMR as necessary.

• Maintain relationships with physician offices through periodic visits/meetings.

• Assist with program financial reporting to client/data collection.

• Cross-train to ambulatory pharmacy; assist with staffing needs as required. This may include weekends and/or holidays as per business needs.

• Provide oversight and direction to associates in accordance with the organization's policies and procedures.

• Coach, mentor, and develop staff, including overseeing new employee onboarding and providing career development and opportunities.

Education:

Current unrestricted pharmacist license in the appropriate state of practice,PharmD degree strongly preferred.
5+ years community/retail/ambulatory pharmacy or health-system related experience. Previous experience in a specialty pharmacy and/or processing prior authorizations is highly desirable.

Skills and Knowledge:

• Must be proficient in Microsoft Office, including Word, Excel, and PowerPoint

• Candidates should have prior experience on pharmacy dispensing systems and be familiar with insurance adjudication processes.

• The role involves working with a broad array of complex disease states and medical conditions; candidates should be comfortable working with clinical data, lab values, and reading/writing notes in patient medical records

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members' ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/cencora

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.

The company's continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned