Clinical Patient Services Advocate - Pharmacy - FT - Day - Stormont-Vail Healthcare : Job Details

Schedule:Full time - 36 hours/week or greaterShift:First Shift (Days - Less than 12 hours per shift) (United States of America)Weekly Work Schedule:8 hours from Mon to Fri. 99% morning shift.Job InformationExemption Status: Non-ExemptA Brief OverviewDetermines, supports, and assists patients and/or families in overcoming financial barriers to medication access with focused expertise in patient enrollment in Medication Assistance Programs and Foundations. Works closely with medical, nursing and pharmacy staff to secure and maintain access to medications for patients in need. The Clinical Patient Services Advocate will centrally coordinate, obtain, review, and track Medication Assistance Program and Foundation enrollments and will act as a financial advocate for the patient.Education Qualifications* Graduate of an accredited practical nursing program is required.Experience Qualifications* 2 years Licensed Practical Nurse (LPN) experience. Required* Healthcare clinic and/or insurance/third party reimbursement experience. Preferred* Experience in customer service. PreferredSkills and Abilities* Strong customer service skills. (Required proficiency)* Able to communicate effectively and work with teams. (Required proficiency)* Able to solve problems independently. (Required proficiency)* Strong organizational skill set. (Required proficiency)* Excellent understanding and use of the EMR. (Required proficiency)* Proficient use of Microsoft Office applications and Microsoft Outlook. (Required proficiency)Licenses and Certifications* Licensed Practical Nurse - KSBN RequiredWhat you will do* Collaborate with physicians, clinic staff, case managers and pharmacy staff to identify potential patients in need of financial assistance.* Conduct patient interviews by phone or in person to determine patient's qualification for Medication Assistance Programs and Foundations by reviewing health/prescription insurance, financial status and other documentation specific to financial assistance program requirements.* Navigate and properly utilize the patient's electronic medical record to obtain clinical information required by financial assistance program.* Communicate effectively with assistance program representatives, patients, physicians, pharmacists and other parties as necessary for enrollment and re-enrollment of patients in Medication Assistance Programs and Foundations.* Support physician clinic staff and specialty pharmacy staff in maintaining prescription refill continuity and facilitating patient enrollment in REMS programs as required by the FDA, reviewing and assisting with prior authorization denial appeals and processing prescription refills.* Assists with quality assurance reviews on denied medical claims. This includes but is not limited to researching denied claims, determining and initiating action to resolve denied claims and intradepartmental collaboration to ensure timely and accurate resolution of denied claims.* Serve as a liaison between physician clinic staff, specialty pharmacy, infusion pharmacy, and other stakeholders to develop and maintain a strong and collaborative partnership between the businesses.* Identify opportunities for the Stormont Vail Pharmacy to partner with prescribers in the development of new initiatives and avenues of service.* Identify areas for process improvement and participate in related activities.* Maintain productivity, quality and customer service requirements according to department policy and procedure.* Complies with Medicare/Medicaid rules and regulations.* Complies with HIPAA/HITECH regulations.Required for All Jobs* Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health* Performs other duties as assignedPatient Facing Options* Position is Patient FacingRemote Work Guidelines* Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards.* Stable access to electricity and a minimum of 25mb upload and internet speed.* Dedicate full attention to the job duties and communication with others during working hours.* Adhere to break and attendance schedules agreed upon with supervisor.* Abide by Stormont Vail's Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually.Remote Work Capability* On-Site; No RemoteScope* No Supervisory Responsibility* No Budget Responsibility No Budget ResponsibilityPhysical Demands* Balancing: Occasionally 1-3 Hours* Carrying: Occasionally 1-3 Hours* Climbing (Ladders): Rarely less than 1 hour* Climbing (Stairs): Occasionally 1-3 Hours* Crawling: Rarely less than 1 hour* Crouching: Rarely less than 1 hour* Driving (Automatic): Rarely less than 1 hour* Driving (Standard): Rarely less than 1 hour* Eye/Hand/Foot Coordination: Frequently 3-5 Hours* Feeling: Occasionally 1-3 Hours* Grasping (Fine Motor): Frequently 3-5 Hours* Grasping (Gross Hand): Occasionally 1-3 Hours* Handling: Occasionally 1-3 Hours* Hearing: Frequently 3-5 Hours* Kneeling: Occasionally 1-3 Hours* Lifting: Occasionally 1-3 Hours up to 50 lbs* Operate Foot Controls: Rarely less than 1 hour* Pulling: Rarely less than 1 hour up to 10 lbs* Pushing: Rarely less than 1 hour up to 10 lbs* Reaching (Forward): Rarely less than 1 hour up to 10 lbs* Reaching (Overhead): Rarely less than 1 hour up to 10 lbs* Repetitive Motions: Occasionally 1-3 Hours* Sitting: Frequently 3-5 Hours* Standing: Occasionally 1-3 Hours* Stooping: Occasionally 1-3 Hours* Talking: Occasionally 1-3 Hours* Walking: Occasionally 1-3 HoursPhysical Demand Comments:Clarity of vision at 20 inches or less and the ability to identify and distinguish colors is essential.Working Conditions* Burn: Rarely less than 1 hour* Chemical: Rarely less than 1 hour* Combative Patients: Rarely less than 1 hour* Dusts: Rarely less than 1 hour* Electrical: Rarely less than 1 hour* Explosive: Rarely less than 1 hour* Extreme Temperatures: Rarely less than 1 hour* Infectious Diseases: Rarely less than 1 hour* Mechanical: Rarely less than 1 hour* Needle Stick: Rarely less than 1 hour* Noise/Sounds: Occasionally 1-3 Hours* Other Atmospheric Conditions: Rarely less than 1 hour* Poor Ventilation, Fumes and/or Gases: Rarely less than 1 hour* Radiant Energy: Rarely less than 1 hour* Risk of Exposure to Blood and Body Fluids: Rarely less than 1 hour* Risk of Exposure to Hazardous Drugs: Rarely less than 1 hour* Hazards (other): Rarely less than 1 hour* Vibration: Rarely less than 1 hour* Wet and/or Humid: Rarely less than 1 hourStormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information. This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment.Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.