MD Anderson Cancer Center Pharmacy Resource Specialist in Houston, Texas
Pharmacy Resource Specialist
Location: United States, Texas, Houston, Houston (TX Med Ctr) at https://mdanderson.referrals.selectminds.com/jobs/12052/other-jobs-matching/location-only
Healthcare/Business Support at http://mdanderson.referrals.selectminds.com/landingpages/healthcarebusiness-support-opportunities-at-md-anderson-cancer-center-12
Requisition #: 116125
The Pharmacy Resource Specialist is a part of the Division of Pharmacy at MD Anderson Cancer Center. We strive to be the industry leader in providing premier patient-centered care, based on excellence and innovation in patient care, services, research and education. We strive to ensure safe, effective and cost-conscious medication use and to work with our health care colleagues to promote optimal drug therapy outcomes through the development of integrated, quality programs.
The Pharmacy Resource Specialist is responsible for the following job specific competencies:
- Analyze patient data to identify potential candidates for enrollment into Pharmacy Patient Assistance Programs and oversee and execute replacement drug orders
Obtain and verify information regarding patients enrolled / or attempting to enroll in vendor sponsored drug replacement programs
Prescreen patients by evaluating documentation to confirm if potential candidates meet the qualifications set forth by vendor sponsored Patient Assistance Programs
Submit required enrollment documentation to PAP for review
Maintain accurate patient records/files
Monitor pharmacy dispense reports and discerns qualified patients based on individual program criteria
Compare medication administration records to physician orders to obtain correct dosing information
Verify third party eligibility using tools provided
Initiate replacement drug orders accurately and timely in accordance with the criteria set forth by the patient assistance program and validate the order was received by the sponsor
Monitor submitted drug orders and verifies shipments are received by MD Anderson in a timely manner
Reconcile replacement drug shipments received to orders placed
Maintain drug replacement inventory records and updates records upon receipt
Facilitate timely resolution of outstanding drug replacement issues
- Ensure documentation and communication are provided in a timely manner
Document clear, concise and complete notes in appropriate system for each case worked
Use excellent written and/or oral communication and listening skills to establish and maintain effective working relationships with internal and external customers to include: pharmacy staff, physicians, nurses, social workers, patient account staff, insurance companies, reimbursement assistance program personnel and others, as necessary, to optimize patient assistance.
- Understand hospital billing processes and Accounts Receivable management
Analyze patient accounts to ensure pharmacy charges appear on the correct account in the hospital billing system
Demonstrate a thorough understanding of patient accounts by analyzing payments, adjustments, or denials to ensure transactions are posted prior to requesting replacement drug or issuing drug replacement adjustments
Initiate adjustments upon receipt of replacement drug to resolve patient balances according to policies and procedures set forth by Pharmacy Financial Services
- Provide oversight of Pharmacy Patient Assistance Programs and Audits
Create and maintain Standard Operating Procedures (SOP) for each PAP based on the criteria set forth by the program and internal department procedures
Stay abreast of changes to institutional, departmental and program policies and procedures and updates SOP’s accordingly
Provide team with updates when program requirements change at monthly team meetings
Prepare for audits initiated by Pharma and/or internal audit by retrieving the requested documentation and preparing patient folders
Evaluate patient files, identifies any potential deficiencies prior to the audit, and communicates findings to management
Employment Status: Regular
Employment Type: Full-Time
Salary Range: $42,400 - $53,000 - $63,600
Required: Bachelor's in Business Administration or related field.
Required: Three years of pharmacy reimbursement, case management, managed care or insurance industry experience. May substitute required education degree with additional years of equivalent experience on a one to one basis.
Preferred: Must have experience working directly with patients or customers. Experience with Pharmacy Assistance Programs or patient, insurance, and hospital billing, including managing approvals and denials would be a plus.
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html