Pharmacy Specialist - Specialty Pharmacy Oncology

Responsibilities

• Performs proper patient assessments that comply with accreditation standards within the time parameters set forth in the patient management program.
• Works to institute a disease state management agreement with providers.
• Cosigns outreach documentation in a timely manner.
• Assesses the appropriateness of therapy for the individual patient with respect to safety, comorbidities, dosing and side effect management.
• Recommends appropriate screening prior to medication start date.
• Recommends appropriate monitoring to ensure patient safety.
• Documents clinical interventions.
• Promotes adherence and actively monitors patient compliance.
• Monitors hospital admissions for their specific patient population.
• Answers clinical communications from patients in a timely manner and facilitates communication between the patient and the clinic.
• Serves as a resource to defend use of product to payers using clinical studies and accepted guidelines.
• Practices evidence-based medicine.
• Develops and manages plans of care collecting objective data to demonstrate positive outcomes.
• Participates in the training of staff, students and residents.
• Participates in a group 24 hours a day 7 days a week 365 days a year on-call rotation where each member of the group takes call for 1 week at a time.
• Serves as a resource and provides accurate drug information to medical staff.
• Actively participates in quality improvement projects and action plans to improve safety and service.
• Sits on the Quality Management Committee.
• Works with drug manufacturers to gain access to limited distribution medications.
• Completes required training in a timely manner.
• Participates in continuing education appropriate to the specialty.
• Can locate patient insurance coverages from multiple sources.
• Performs an accurate benefit investigation to determine prescription coverage.
• Processes prescriptions expeditiously.
• Possesses advanced knowledge of the adjudication process and can troubleshoot rejected claims and mitigate payer problems.
• Serves as a resource to others in processing clean claims.
• Knowledgeable in the prior authorization process and able to submit requests accurately and expediently.
• Serves a resource for off label use prior authorizations and appeals.
• Trains staff on the prior authorization process.
• Can access co-pay cards and grants for financial assistance.
• May perform other duties as assigned.