Specialty Pharmacy Liaison II
Serves as a single point of contact for program specific Specialty Pharmacies (SPs) and/or the manufacturer’s Sales Force. Responsible for reviewing, analyzing, identifying, and solving problematic issues and escalations. Provide timely and accurate reconciliation of SP dispensing information, builds and develops strong SP-HUB relationships, and support all activities that facilitate patient access. As applicable, builds and develops strong Sales Force-HUB relationships. Utilize knowledge of specialty pharmacy processes, dispensing patterns and reimbursement issues to effectively detect and investigate potential gaps in care. Participates in the manufacturer/SP Quarterly Business Reviews (QBRs) and other meetings as requested. Provides training to the SPs for program, processes and data.
- Bachelor’s Degree and 3-5 years of experience or 8-11 years relevant working experience
- 5 years experience in a customer service setting, preferably in a call center environment
- Previous experience in the PBM and/or healthcare industry required
- Demonstrated team lead experience preferred
- Proficient in Microsoft Office applications
- Ability to handle a fast paced environment
- Strong written and verbal communication skills
- Advanced problem solving and trouble-shooting skills
- Strong attention to detail
- Strong team building skills and the ability to train other team members
- Research, analysis, report preparation and documentation skills
- Demonstrated customer service resolution skills
Specific Job Duties:
- Provide consistent and effective communication to all appropriate stakeholders as first line support/single point of contact with contracted specialty pharmacies.
- Identify, investigate and resolve escalated issues and cases related to complex reimbursement from both internal and external stakeholders.
- Responsible for analyzing incoming data and recognizing trends and cases that need further action. Review all incoming daily data from the contracted SP, review exception errors generated from each contracted data feed, and outreach to contracted SPs related to outstanding restatements. Ensure all contractual timeframes related to SP data review are successfully met, if applicable.
- Lead weekly (more or less frequently as needed) calls with each contracted SP to review patient statuses to include those at risk of lapsing in therapy, shipment and/or insurance delays, missing shipment and updates. Provide timely tracking of receipt of referral, status of contracted SP activity, and potential interruptions in therapy.
- Provide training and education to contracted SPs about the program, processes, and data requirements.
- Gathers, analyzes, and prepares data, including Adverse Event trending, for Quarterly Business Reviews (QBRs), FDA requirements, and other special projects and reports as applicable.
- Attends manufacturer national sales conferences as applicable.
- Attends manufacturer/SP QBRs and other manufacturer meetings as requested.