Job Summary: This position supports the director of pharmacy in the following manner:
- Processes prior authorizations on behalf of Heart of Ohio Family Health (HOFH) prescribing Clinicians
- Assists in the maintenance of the 340B program.
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Provides operational support to in-house pharmacies by practicing as a Registered/Certified Pharmacy Technician, when needed.
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Provides administrative support to leadership, where needed.
Reports to: Director of Pharmacy
Supervises: N/A
Dress Requirement: Business casual and/or scrubs in accordance with the Heart of Ohio Family Health dress code policy
Work Schedule: Full Time
Monday through Friday during standard business hours
Times are subject to change due to business necessity
þ Non-Exempt
Job Duties and Responsibilities:
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Prior Authorizations
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Work with internal and external pharmacies, CoverMyMeds (CMM), the EHR (Epic) and Heart of Ohio Family Health Clinicians to complete prior authorizations.
- Maintain excellent oral and written communication with Clinicians and through the EHR as it relates to the status of prior authorizations and all required 340B documentation.
- Maintain open lines of communication between providers, pharmacies, and patients as it relates to the status of prior authorizations.
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Complete prior authorizations within established time frame
- Ensure proper documentation is maintained within the EHR.
- Work with clinical pharmacist team to provide potential therapeutic substitutions to prescribers.
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340B Support
- Work directly the 340B Analyst to provide support to the 340B program. Duties could include:
- Maintain 340B compliance, program integrity and financial optimization for all participating covered entities.
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Complete, validate and document completed audits related to 340B program compliance.
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Ensure compliance with HOFH 340B policies and procedures.
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Establish and maintain excellent relations with individuals, committees, and other stakeholders in the 340B program.
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Assists with ensuring HRSA requirements for the program are met.
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Continuously works to improve the 340B program performance through surveillance and program optimizations.
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Responsible for immediate communication and escalation of 340B compliance related issues or operational gaps.
- Creates and maintains reports of 340B program metrics as established by the organization.
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Works with third party administrators (TPA) to maintain the HOFH contract pharmacy network.
- Participates in 340B oversight sub-committees established by HOFH to ensure program integrity.
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Provides education to covered entity staff members.
- Support to In-House Pharmacy Staff:
- Support of pharmacy services by assembling and dispensing medications in an efficient, accurate and patient-centered manner
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Process prescriptions via paper and electronic prescription formats.
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Adjudication of prescriptions through insurance while being conscious of out-of-pocket costs and exploring ways to provide patients with medications at the lowest possible cost.
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Respond to requests from providers and patients via phone, computer, and face-to-face interactions.
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Assisting in the maintenance of records in accordance with company policy and state/federal law
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Inventory management which includes, but not limited to, annual controlled substance inventory and daily maintenance of in-stock medications and supplies.
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Non-sterile compounding
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Maintenance of active registration throughout employment with the Ohio State Board of Pharmacy is required.
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Attention to detail, analytical skills, admirable customer service and dependability is a must.
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A positive attitude with a passion for providing high-quality, holistic, and compassionate care to every patient every time.
- A willingness to continuously grow, learn and accept different cultures in an environment surrounded by great diversity.
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Maintain compliance with Ohio State Board of Pharmacy licensing requirements and Heart of Ohio Health Relias training (and others as necessary)
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Provide requested data to leadership, when needed.
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Provides additional pharmacy administrative support.
Equipment Operated: Pharmacy Equipment
Telephone
Computer
Printer
Fax machine
Copier
Other office equipment as assigned
Facility Environment:
Heart of Ohio Family Health operates in multiple locations, in Columbus, OH. All facilities have a medical office environment with front-desk reception area, separate patient examination rooms, nursing stations, pharmacy stock room, business offices, hallways and private toilet facilities.
This position’s primary work area is within the pharmacy on the second floor (elevator access on site).
The pharmacy area:
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kept at a normal working temperature
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sanitized daily
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maintains standard pharmacy environment with minimal opportunities to sit, long hours standing
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maintains standard office equipment; i.e., computer, copier, fax machine, etc. at a normal working heigh
Physical Demands and Requirements: these may be modified to accurately perform the essential functions of the position:
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Mobility = ability to easily move without assistance
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Bending = occasional bending from the waist and knees
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Reaching = occasional reaching no higher than normal arm stretch
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Lifting/Carry = ability to lift and carry a normal stack of documents and/or files
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Pushing/Pulling = ability to push or pull a normal office environment
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Dexterity = ability to handle and/or grasp, use a keyboard, calculator, and other office equipment accurately and quickly
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Hearing = ability to accurately hear and react to the normal tone of a person’s voice
- Visual = ability to safely and accurately see and react to factors and objects in a normal setting
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Speaking = ability to pronounce words clearly to be understood by another individual
Job Qualifications (Experience, Knowledge, Skills and Abilities:
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Must be 18 years of age or older.
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High school diploma or equivalent
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Registration (Registered/Certified) with the Ohio State Board of Pharmacy required.
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National certification from an accredited pharmacy technician certification program (PTCB, ExCPT, etc.), preferred.
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Previous pharmacy experience required.
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Knowledge of the 340B program preferred.
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Previous experience processing prior authorization preferred.
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Previous experience with Epic or PioneerRx preferred.
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Understanding of laws and regulations impacting the medication dispensing process preferred
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Prefer an understanding of third-party payer benefits, the requirements and troubleshooting rejected claims.
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Ability to accurately enter data, preferably typing at a minimum of 45 wpm.
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Ability to accurately input prescriptions and/or other information as dictated by the pharmacist.
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Has the ability to diffuse and handle difficult situations by using good judgment, control of emotion and diplomacy.
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Demonstrates grammatically correct verbal and written communication skills.
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Demonstrates efficient and courteous telephone skills.
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Demonstrates resilience, a positive attitude and the ability to work well in a fast paced, rapidly changing environment.
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Ability to work in a team setting and/or with minimal supervision.
