Essential Functions/Responsibilities:

Essential functions are the duties and responsibilities that are essential to the position (not a task list). Do not include if less than 5% of work time is spent on this duty. Be specific without giving explicit instructions on how to perform the task. Do not include duties that are to be performed in the future. Duties should be action oriented and avoid vague or general statements.

% of Time

(annually)

• 
  Receives, validates and clarifies, and processes prescription orders.

• Gather all required information for prescription processing including demographics, insurance coverage, allergies, past and current medication use, diagnoses/comorbidities, past medical history, and all relevant information needed for safe and appropriate medication use.

• Processing of prescription orders. Documentation, clarification, and communication to patient or other healthcare personnel medical information related to: therapeutic appropriateness, therapeutic duplication, dose/direction/frequency/route appropriateness, adherence issues, prospective/concurrent/retrospective drug utilization review, side effects or adverse effects, laboratory and/or clinical monitoring, potential interactions with drug/food/diagnostic testing/pregnancy/etc., effectiveness and patient outcomes, toxicity, and other therapy related issues to maintain complete patient record.

• Maintain appropriate and comprehensive knowledge of specialty medications and other drug related information to remain abreast of relevant current clinical practices.

• Receives incoming calls from patients, providers, and other healthcare professionals and answers questions/concerns appropriately or is able to coordinate with the appropriate service line/person to adequately find answers.

• Telephonically conducts medication counseling and therapy management including education of proper administration by patient or caregiver, therapy management assessments, and adherence monitoring in order to measure appropriate outcomes, instruct on patient safety issues and improve overall patient health.

• Receives calls regarding side effect management, adverse event reporting, dispensing or shipping errors, and determines resolutions that result in positive outcomes.

• Supervises the patient management program.

• 
  Specializes in specialty pharmacy medications, but also has working knowledge of all service lines provided by UnityPoint Health and can coordinate care with any available resources that a patient may need.

• Able to direct requests to appropriate services needed for optimal patient care.

• Establishes and maintains positive working relationships with current and potential referral sources.

• Builds and delivers exceptional patient and customer service to uphold the expectations that the Specialty Pharmacy is the provider of high quality services.

• 
  Initiates, coordinates, processes and follows up on benefits investigation and prior authorization to obtain approval from payers on behalf of the patient and provider. Maintain a working knowledge of guidelines and criteria for specialty medications set by third party payers.

• Tracks order status and works to resolve outstanding issues.

• Fulfillment of prescription orders including verification of appropriate medication, supplies, delivery method, and cold chain processes to ensure patient receives orders at the time needed with all relevant supplies to administer appropriately at a time and place convenient to the patient.

• Ensures appropriate documentation is maintained in accordance with all regulatory, self-imposed, FDA, REMS, and accreditation requirements.

• Maintains a working knowledge of relevant regulations affecting patients and the operation of our business.

• On-call and other duties may be required on a rotation basis and assigned by manager.

Basic UPH Performance Criteria

• Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.

• Demonstrates ability to meet business needs of department with regular, reliable attendance.

• Employee maintains current licenses and/or certifications required for the position.

• Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.

• Completes all annual education and competency requirements within the calendar year.

• Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.

Minimum Requirements

Identify items that are minimally required to perform the essential functions of this position.

Preferred or Specialized

Not required to perform the essential functions of the position.

Education:

• 
  Bachelor’s degree in Science or Pharm D. degree.
• Graduate of an accredited school of pharmacy.

Experience:

• 
  Strong interpersonal skills.

• Strong problem solving skills with previous customer service experience.

• Basic knowledge of computer applications (i.e. Word, Excel) and operations.

• Ability to work as a collaborative team member.

• Ability to understand and apply guidelines, policies and procedures.

• 
  Two years previous pharmaceutical experience in home infusion or specialty pharmacy.
• Knowledge of medical terminology, anatomy and physiology.
• Knowledge of medical billing and collection practices.

License(s)/Certification(s):

• 
  Current unrestricted license to practice pharmacy in the state where service is provided.

• Mandatory Reporter: Child & Dependent Adult Abuse.

Knowledge/Skills/Abilities:

• 
  Microsoft Office (Outlook, Word, Excel, PowerPoint, OneNote)

• Capable of working independently

Other:

Use of usual and customary equipment used to perform essential functions of the position.