Specialty Pharmacist Navigator
Core
Navigate specialty pharmaceutical prescriptions for patients by coordinating with physicians, processing authorizations, and ensuring medication access and delivery.
Role type
Specialty Pharmacist Navigator (Senior IC)
Builds
Patient medication access and workflow for specialty pharmaceuticals
Domain
Healthcare / Specialty Pharmacy
Deliverable
client delivery
Required skills
Insurance adjudication, prior authorization management, patient profile management, prescription processing, clinical data interpretation, financial advocacy, staff coaching
Preferred skills
PharmD degree, specialty pharmacy experience, pharmacy dispensing systems proficiency
Technologies
Microsoft Office, pharmacy dispensing systems
Responsibilities
Access physician practices for specialty Rx value; establish communication with targeted specialty practices; process prescriptions including insurance adjudication and product sourcing; prepare and submit prior authorization paperwork; manage denials; triage limited distribution or out-of-network drugs; act as financial advocate for patients; coordinate pickup/courier delivery of prescriptions; follow up with patients to ensure refills and address clinical questions; maintain relationships with physician offices; assist with program financial reporting; cross-train to ambulatory pharmacy; provide oversight and direction to associates; coach and mentor staff.
Seniority
Senior, hands-on IC with leadership responsibilities