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Specialty Pharmacy Medication Authorization Tech

Employer
University of Virginia
Location
Charlottesville, VA
Closing date
Aug 3, 2021

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Job Details

Job location: Charlottesville, VA


Employment Type: Full-time
Posted data: 2021-07-12
Req: R0025703
The Pharmacy Medication Authorization Technician evaluates and obtains medication authorizations for all patients. This may include authorizations covered under the medical benefit as well as the pharmacy benefit of a health insurance plan. The job may also require patient eligibility and investigation for pharmaceutical medication assistance programs. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a patient care setting. The purpose is to support patients’ access to medications and ensure the minimum loss of revenue and maximum payment for medications. The ability to maintain a working knowledge of carrier contracts and changes as well as departmental policies and procedures is required. The Pharmacy Medication Authorization Technician is able to complete the duties of a general, cross-trained, and specialist pharmacy technician.

  • Analyzes information required to complete medication authorizations with insurance carriers, service area contacts, and workman’s compensation carriers.
  • Accurate and pertinent clinical data and demographics is compiled and communicated to the patients’ insurance company in a timely and organized fashion.
  • Medication authorization services are understood and integrated in accordance with Health System and departmental policies and procedures by working collaboratively with designated contacts in service areas.
  • Knowledge of insurance company criteria for medication approval is current.
  • Authorization approval procedures are communicated to insurance carriers via telephonic/fax/on-line review in an organized and timely fashion.
  • Timely follow-up with insurance carriers is performed to obtain certification/authorization documentation for inpatient and outpatient services.
  • Demonstrates skill in the proficient use of PC and UVA software systems to ensure that all medication authorization information is entered into required computer systems in an accurate and timely manner. On-line data entry of authorizations and denials are communicated to appropriate personnel. Proficiency in the use of PC and required UVA software systems is appropriately demonstrated. Accuracy and Quality of medication authorization documents are maintained for organized retrieval of patient records. Specific support functions are handled in an organized and timely fashion.
  • Demonstrates the skills of effective communication, decision-making, and organization to ensure efficient job performance and job success.
  • Daily work is accomplished with minimal direct supervision.
  • Work priorities are set in order to accomplish tasks/goals.
  • Confidential matters are handled appropriately.
  • Familiarity with all relevant insurance plans and formularies is demonstrated.
  • Communication with Department billing staff is accomplished in a timely manner to ensure accurate medication authorization information is aligned with accurate billing of services.
  • Ability to train staff and to act as a resource to other staff is demonstrated at all relevant times.
  • Comprehension of insurance data, benefits, in/out of network issues, notification requirements, and medical diagnosis is consistently demonstrated in order to ensure that all medication authorizations are completed prior to the date of service.
  • Sound judgment is consistently demonstrated as to when to involve pharmacists, physicians, or other health care professionals in the medication authorization or denial process.
  • Prepares medications for dispensing to patients:
  • Receives medications from pharmaceutical manufacturers on behalf of specific patients.
  • Enters prescription orders into pharmacy software application for prescription dispensing labeling according to all governing statutes and regulations including pharmacy department policies and procedures.
  • After pharmacist checking of prescription and appropriate medication, coordinates pick up or shipping of the dispensed medication to the patient.
  • Evaluates patient eligibility for pharmaceutical medication assistance:
  • Evaluates pharmaceutical manufacturer criteria for patient eligibility.
  • Utilizes internet programs, vouchers, copay-coinsurance assistance programs, and any other program knowledge.
  • Completes manufacturer application forms or assists patient/caregiver with the forms.
  • Evaluates patient financial information currently available in UVA software systems, demonstrates proficient access and ability to look up pertinent information in data-containing applications, and applies available information to the specific manufacturer program to reduce paperwork burden to the patient.
  • Assists patients with Medicare part D open enrollment, new enrollment, enrollment or eligibility changes, and plan (PDP or MAP) changes, formulary changes, or plan errors:
  • Manages open enrollment appointments by phone, appointment, or walk-in.
  • Provides unbiased information and assistance to patients.
  • Assists pharmacy staff when patient-plan issues needing intervention occur.
  • Seeks additional help for patients with no gap coverage, medications not covered by the enrolled-plan from other assistance organizations on behalf of the patient/caregiver.
  • Maintains current working knowledge of alternate assistance organizations.
  • Continually seeks and finds new ideas and solutions for increasing medication savings for the Organization and patients:
  • Meets regularly with other health care providers.
  • Meets regularly with manufacturer representatives.
  • Attends local, regional, or national meetings for training and updating knowledge of assistance programs.
  • Pursues individual training/learning opportunities to benefit the program.
  • Demonstrates superior customer service:
  • Demonstrates superlative organizational skills, including, but not limited to Microsoft Office products (Word, Excel, PowerPoint, and Access).
  • Demonstrates compassion, kindness, friendliness, and grace to every patient/caregiver and health care team member.
  • Manages communication efficiently: returns phones calls with 24 hours of message (reported), returns pages immediately (by next morning at latest) (reported).
  • Provides patients and health care providers realistic expectations of medication authorization assistance.
  • Updates patients and providers with program changes and status of approvals or denials.
  • In addition to the above job responsibilities, other duties may be assigned.
Position Compensation Range: $17.31 - $26.83 Hourly

MINIMUM REQUIREMENTS

Education: High School Graduate or Equivalent required.

Experience: Three years of relevant experience required.

Licensure: Commonwealth of Virginia Pharmacy Technician License required. National Pharmacy Technician Certification required.

PHYSICAL DEMANDS

Job requires standing for prolonged periods, frequently bending/stooping, reaching (overhead, extensive, and repetitive); Repetitive motion: computer keyboard.  Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly;

The University of Virginia, including the UVA Health System which represents the UVA Medical Center, Schools of Medicine and Nursing, UVA Physician’s Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.

Organization

In 1819, the University of Virginia established a new model for intellectual exchange and cross-disciplinary collaboration in higher education. Two hundred years later, as a major research institution, we continue to challenge conventions, lead with ingenuity and advance knowledge for the common good.

What began as an innovative idea has become one of the nation’s leading public research universities, with over 21,000 undergraduate, graduate and professional students. UVA also has over 3,000 full-time faculty offering more than 400 degrees.

Each of the University’s eleven schools has its own distinctive mission, working together to garner consistently high rankings—including #2 Best Value Public College (Princeton Review, 2016), #3 Public University in the Nation (U.S. News & World Report, 2016), and #3 Best Value Among Public Colleges (Kiplinger’s, 2016).  

As we invest in and strengthen our research capabilities, UVA seeks new faculty ready to uncover new insights, rewrite old rules and collaborate on intellectual discoveries.

RESEARCH COLLABORATIONS THAT CROSS DISCIPLINES

As an R1 institution, the University’s research centers, consortia and laboratories are on the leading edge of discovery and technology, offering collaborative spaces for students and faculty to solve global problems.

Our professors are recognized members of major national scholarly and professional organizations, including the National Academy of Sciences and the American Academy of Arts and Sciences. Our faculty’s engagement in interdisciplinary research is being facilitated by new research institutes specializing in everything from big data to brain functioning, and by cluster hires across schools.

NATIONALLY RANKED HEALTH SYSTEM

UVA is also home to a nationally renowned academic medical center and the UVA Health System, which serves a three-part mission to treat patients, conduct translational research and train medical practitioners in a wide variety of disciplines.

Established as the nation’s 10th medical school in 1825, the institution has since grown to include a 612-bed hospital and a Level I trauma center, nationally recognized cancer and heart centers, a Children’s Hospital, and primary and specialty clinics throughout Central Virginia.

The UVA Medical Center is consistently ranked among the nation’s best hospitals by the U.S. News & World Report magazine and has been named among the top 25 percent in seven specialties.

INSPIRING STUDENTS, INSPIRED TEACHING

The vast majority of UVA students come from the top 10% of their high school class, as well as from all 50 states, over 142 countries and a variety of socioeconomic backgrounds. Despite their diversity, all UVA students share a love of learning and a drive to achieve.

One of the reasons students choose Virginia is our unique residential culture. At UVA, the community of students, faculty and staff personifies the Jeffersonian idea that living and learning are connected. The Academical Village was constructed to support a unique residential experience, with faculty living in the Pavilions, students occupying Lawn rooms and the world-famous Rotunda at its heart. The University’s residential culture continues to support this experience today—strengthened by students, faculty and staff rich in backgrounds, ideas and perspectives. Our unique culture is also paying dividends in innovation:  UVA’s faculty have generated more than 130 patents since 2010.

Perhaps most importantly, faculty come to UVA knowing that instruction is as important as research, and they pride themselves on their many teaching awards.  Our best professors look for ways to encourage, mentor and develop tomorrow’s leaders inside and outside the classroom.

LIFE IN CHARLOTTESVILLE

Living in Charlottesville you’ll find sophisticated restaurants, world-renowned wineries and breweries, cosmopolitan arts and music, friendly urban and suburban neighborhoods and a Piedmont landscape that has lured adventurous souls for centuries.  No wonder the U.S. National Bureau of Economic Research named Charlottesville the “happiest city in America” in 2014.

In addition to UVA and its health system, several major employers have facilities in Charlottesville, including State Farm, Northrop Grumman, the U.S. Department of Defense, GE and others.  Charlottesville is also becoming a center for innovative start-up businesses.  The University also actively helps spouses and partners of faculty members build their networks and pursue employment opportunities with a wide variety of area employers. 

The University of Virginia is an equal opportunity and affirmative action employer. Women, minorities, veterans, and persons with disabilities are encouraged to apply. In accordance with the Americans with Disabilities Act Amendments Act of 2008 (ADAAA) and the Rehabilitation Act of 1973, qualified individuals with disabilities are protected from discrimination and may be entitled to reasonable accommodations to assist in their pursuit of employment at the University. This includes assistance in completing the online job application as well as reasonable accommodations during the interview process. Please contact the UHR Service Center: 434.982.0123 orAskHR@virginia.edu to request assistance.

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