Pharmacy Prior Auth Specialist
Pharmacy Prior Auth Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
WHO WE ARE & WHAT WE DO
Tallahassee Memorial Healthcare (TMH) is a private nonprofit community-based healthcare system that provides care to a 22-county region in North Florida and South Georgia. We are a career destination with over 6000 colleagues who reflect the diversity of our community.
TMH is the regions healthcare leader and top provider of advanced care with a 772-bed acute care hospital and the regions only:
- Level II Trauma Center
- Primary Stroke Center
- Level III Neonatal Intensive Care
- Pediatric Intensive Care
- The most advanced cancer heart and vascular orthopedic & surgery programs in the Panhandle.
Our system also includes a psychiatric hospital multiple specialty care centers six residency programs and more than 50 affiliated physician practices.
HOW YOULL MAKE AN IMPACT
Your Role:
Verifies eligibility obtains insurance benefits and ensures pre-certification authorization and referral requirements are met prior to medication delivery.
Utilizes a proactive approach to ensure timely approvals facilitating high-quality patient care.
Manages prior authorizations and supports the 340B Drug Pricing Program.
Maintains documents and records.
Audits documents to ensure regulatory compliance.
Collaborates with healthcare providers physicians and clinical staff members.
Reports To:
Prog/Specialty Pharm Mgr 340B
Supervises:
- None
WHAT YOULL NEED TO APPLY
Required Education:
High school diploma or equivalent (e.g. certificate of high school equivalency).
Preferred Education:
- Associate degree in Healthcare Administration Business Administration or other Healthcare field.
Required Experience:
- Two (2) years of Healthcare Medical Billing or related experience.
Preferred Experience:
- Retail of Specialty Pharmacy experience.
Required Certification/License/Registry:
Prior Authorization Certified Specialist (PACS) credential from the Accreditation Council for Medical Affairs (ACMA) within six (6) months post-hire.
Certified Pharmacy Technician (CPhT) credential from the Pharmacy Technician Certification Board (PTCB) or the National Healthcareer Association (NHA) within (6) months post-hire.
Preferred Certification/License/Registry:
340B Operations Certificate issued by Apexus.
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Tallahassee Memorial HealthCare is an equal opportunity employer and drug-free workplace. All employment is contingent upon successful completion of a drug screen background check reference verification health assessment and credential/license verification.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
