Medical Faculty Associates, Inc.
Lead Prior-Authorization Technician
Medical Faculty Associates, Inc., Arlington, Virginia, United States, 22201
3811 N Fairfax
3811 N Fairfax Drive
Arlington, VA 22203, USA
Position Summary To lead the development and coordination of the prior authorization team as they serve the GWMFA providers. Serve as a member of the Specialty Pharmacy team.
Essential Duties and Responsibilities To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
Under the supervision of a licensed Pharmacist:
Maintain effective onboarding and training procedures for team members
Perform continuous quality improvement of prior authorization and pharmacy-initiated refill program
Manage time and attendance, payroll, and PTO requests for the team
Initiate prior authorizations for medications and work with providers on completion
Confirm patient demographics are accurate and insurance information is correct
Communicate with the clinical team and patients about prior authorization and refill status and provide updates accordingly
Identify patient foundation assistance and manufacturer copay assistance programs
Follow up with the pharmacy to ensure the medication is in process after approval was received
Process prior authorization renewals
Work with the provider to resolve prior authorization peer-to-peer reviews and denials
Transcription of new prescriptions to patient profile
Ensure correct third-party adjudication of specialty medications
Communicate with nurses and patients about prescription order status and provide updates accordingly
Communicate copays with patients before ordering medications
Make sure that specialty medications with existing PAR levels are appropriately stocked
Notify the patient when medication is available for pickup and/or schedule delivery
Basic familiarity with proper medication dosing, use, and required monitoring parameters for specialty medications
Perform refill reminders for patients on specialty medications and follow up with the prescriber if out of refills
File all completed prescriptions in accordance with department standards
At all times, maintain a courteous interaction with patients, visitors, departments, and medical personnel
Compliance with all established personnel and departmental policies
Preparation of prescriptions for pharmacist’s review, following federal and local regulations (including labeling)
Refer issues that require professional judgment to a pharmacist for follow-up
Minimal Qualifications Education
High school diploma or an equivalent combination of training and experience.
Licensure
Current and valid licensure as a Pharmacy Technician in the District of Columbia.
Experience
A minimum of 2 years of verified Pharmacy Technician experience in a retail, nursing home, medical center, or hospital pharmacy
Physical Requirements
Stand, walk, bend, twist, and reach for long periods of time in a clinical setting.
Must be able to occasionally lift or carry and push or pull up to 100 lbs. as part of the role
Regularly exposed to healthcare settings that may require personal protective equipment
Requires manual dexterity to operate a computer keyboard, calculator, copier machine, and other equipment.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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Position Summary To lead the development and coordination of the prior authorization team as they serve the GWMFA providers. Serve as a member of the Specialty Pharmacy team.
Essential Duties and Responsibilities To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
Under the supervision of a licensed Pharmacist:
Maintain effective onboarding and training procedures for team members
Perform continuous quality improvement of prior authorization and pharmacy-initiated refill program
Manage time and attendance, payroll, and PTO requests for the team
Initiate prior authorizations for medications and work with providers on completion
Confirm patient demographics are accurate and insurance information is correct
Communicate with the clinical team and patients about prior authorization and refill status and provide updates accordingly
Identify patient foundation assistance and manufacturer copay assistance programs
Follow up with the pharmacy to ensure the medication is in process after approval was received
Process prior authorization renewals
Work with the provider to resolve prior authorization peer-to-peer reviews and denials
Transcription of new prescriptions to patient profile
Ensure correct third-party adjudication of specialty medications
Communicate with nurses and patients about prescription order status and provide updates accordingly
Communicate copays with patients before ordering medications
Make sure that specialty medications with existing PAR levels are appropriately stocked
Notify the patient when medication is available for pickup and/or schedule delivery
Basic familiarity with proper medication dosing, use, and required monitoring parameters for specialty medications
Perform refill reminders for patients on specialty medications and follow up with the prescriber if out of refills
File all completed prescriptions in accordance with department standards
At all times, maintain a courteous interaction with patients, visitors, departments, and medical personnel
Compliance with all established personnel and departmental policies
Preparation of prescriptions for pharmacist’s review, following federal and local regulations (including labeling)
Refer issues that require professional judgment to a pharmacist for follow-up
Minimal Qualifications Education
High school diploma or an equivalent combination of training and experience.
Licensure
Current and valid licensure as a Pharmacy Technician in the District of Columbia.
Experience
A minimum of 2 years of verified Pharmacy Technician experience in a retail, nursing home, medical center, or hospital pharmacy
Physical Requirements
Stand, walk, bend, twist, and reach for long periods of time in a clinical setting.
Must be able to occasionally lift or carry and push or pull up to 100 lbs. as part of the role
Regularly exposed to healthcare settings that may require personal protective equipment
Requires manual dexterity to operate a computer keyboard, calculator, copier machine, and other equipment.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr