Michigan Staffing
Medication Care Coordination Team Position
The Medication Care Coordination Team (MCC) is a centralized team that works closely with six departments to help obtain prior authorizations for high-cost medications, quantity limits, tier exceptions, and non-formulary medications that are ordered by providers. The MCC team covers multiple provider offices and specialties and collaborates with insurance companies, pharmacies, and Corewell Health clinics to obtain the necessary information for completing a prior authorization and ensuring accurate prescription processing at the destination pharmacy. Specialty Pharmacy Scope of Work: Coordinates prior authorization and prescription processing in collaboration with the Corewell Health Specialty Pharmacy (CHSP) staff for specialty medications prescribed for patients of select Corewell Health clinics. Additionally, these liaisons support prior authorization and specialty prescription coordination for specialty medications that are filled at any external specialty pharmacy when prescribed from the covered clinics. Works in collaboration with clinic and pharmacy staff to facilitate patient access to specialty medications and drive utilization of internal specialty pharmacy services. Performs insurance benefit investigations and prior authorizations to facilitate appropriate access to specialty medications. Coordinates financial assistance through manufacturer and third-party programs to ensure patient affordability. Resolves various adjudication errors and rejections. Communicates directly with prescribing clinic/office staff, patients, and insurance companies to arrange timely approval, fulfillment, and delivery of medications. Provides exceptional customer service through telephone and/or in-person communications. This position may be based within a clinic or in the specialty pharmacy depending upon need. Responsibilities include: Pulls, transcribes, and organizes clinical information from patient charts into third party platforms or navigators. Performs all necessary aspects of the medication prior authorization process, including obtaining required medical information, completing paperwork or electronic submission of prior authorization forms, and communicating with third party payers as necessary to obtain approval and prevent therapy interruptions. Performs prescription data entry, adjudicates claims, and resolves third party exceptions. Identifies patients eligible for financial assistance through manufacturer-provided or third-party sponsored programs. Facilitates patient enrollment in programs to reduce out-of-pocket expense. Documents activities in the appropriate system(s) to provide a record of care and facilitate handoff among various team members. Provides exceptional customer service to patients, provider office staff, and all outside business associates. Develops collaborative working relationships with providers, clinics, and office staff. Provides education to patients and clinic staff on the benefits and services provided by the Specialty Pharmacy. Facilitates patient enrollment in the Specialty Pharmacy Patient Management Program. Responsible for data collection and/or reporting related to assigned area/projects as needed. Serves as a role model and leader in the department. Escalates any concerns that are identified in their area of work through chain of command. Participates in training pharmacy team members. Qualifications: Required: High School Diploma or equivalent Required: 2 years of relevant experience in Pharmacy Preferred: Retail or specialty pharmacy experience Required: LIC-Pharmacy Technician - STATE_MI State of Michigan Upon Hire Required: CRT-Pharmacy Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board Upon Hire Ideal candidate will be a Pharmacy Technician possessing Full Michigan Pharmacy Technician License and National Pharmacy Technician Certification, such as PTCB or ExCPT Ideal candidate will also possess either Specialty Pharmacy experience or Retail Pharmacy experience This is a position that will require 2-4 Weeks of On-Site Training in Grand Rapids, Michigan, and then will allow this person to work from home, ideally within commuting distance to Grand Rapids, Michigan Schedule will be Monday to Friday, 8 AM to 5 p.m., No Weekends How Corewell Health cares for you: Comprehensive benefits package to meet your financial, health, and work/life balance goals. Primary Location: SITE - Corewell Health Care Center - Wealthy - 1900 Wealthy - Grand Rapids Department Name: Corporate Admin - Medication Care Coordination Employment Type: Full time Shift: Day Weekly Scheduled Hours: 40 Hours of Work: 8 a.m. to 5 p.m. Days Worked: Monday to Friday Weekend Frequency: N/A
The Medication Care Coordination Team (MCC) is a centralized team that works closely with six departments to help obtain prior authorizations for high-cost medications, quantity limits, tier exceptions, and non-formulary medications that are ordered by providers. The MCC team covers multiple provider offices and specialties and collaborates with insurance companies, pharmacies, and Corewell Health clinics to obtain the necessary information for completing a prior authorization and ensuring accurate prescription processing at the destination pharmacy. Specialty Pharmacy Scope of Work: Coordinates prior authorization and prescription processing in collaboration with the Corewell Health Specialty Pharmacy (CHSP) staff for specialty medications prescribed for patients of select Corewell Health clinics. Additionally, these liaisons support prior authorization and specialty prescription coordination for specialty medications that are filled at any external specialty pharmacy when prescribed from the covered clinics. Works in collaboration with clinic and pharmacy staff to facilitate patient access to specialty medications and drive utilization of internal specialty pharmacy services. Performs insurance benefit investigations and prior authorizations to facilitate appropriate access to specialty medications. Coordinates financial assistance through manufacturer and third-party programs to ensure patient affordability. Resolves various adjudication errors and rejections. Communicates directly with prescribing clinic/office staff, patients, and insurance companies to arrange timely approval, fulfillment, and delivery of medications. Provides exceptional customer service through telephone and/or in-person communications. This position may be based within a clinic or in the specialty pharmacy depending upon need. Responsibilities include: Pulls, transcribes, and organizes clinical information from patient charts into third party platforms or navigators. Performs all necessary aspects of the medication prior authorization process, including obtaining required medical information, completing paperwork or electronic submission of prior authorization forms, and communicating with third party payers as necessary to obtain approval and prevent therapy interruptions. Performs prescription data entry, adjudicates claims, and resolves third party exceptions. Identifies patients eligible for financial assistance through manufacturer-provided or third-party sponsored programs. Facilitates patient enrollment in programs to reduce out-of-pocket expense. Documents activities in the appropriate system(s) to provide a record of care and facilitate handoff among various team members. Provides exceptional customer service to patients, provider office staff, and all outside business associates. Develops collaborative working relationships with providers, clinics, and office staff. Provides education to patients and clinic staff on the benefits and services provided by the Specialty Pharmacy. Facilitates patient enrollment in the Specialty Pharmacy Patient Management Program. Responsible for data collection and/or reporting related to assigned area/projects as needed. Serves as a role model and leader in the department. Escalates any concerns that are identified in their area of work through chain of command. Participates in training pharmacy team members. Qualifications: Required: High School Diploma or equivalent Required: 2 years of relevant experience in Pharmacy Preferred: Retail or specialty pharmacy experience Required: LIC-Pharmacy Technician - STATE_MI State of Michigan Upon Hire Required: CRT-Pharmacy Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board Upon Hire Ideal candidate will be a Pharmacy Technician possessing Full Michigan Pharmacy Technician License and National Pharmacy Technician Certification, such as PTCB or ExCPT Ideal candidate will also possess either Specialty Pharmacy experience or Retail Pharmacy experience This is a position that will require 2-4 Weeks of On-Site Training in Grand Rapids, Michigan, and then will allow this person to work from home, ideally within commuting distance to Grand Rapids, Michigan Schedule will be Monday to Friday, 8 AM to 5 p.m., No Weekends How Corewell Health cares for you: Comprehensive benefits package to meet your financial, health, and work/life balance goals. Primary Location: SITE - Corewell Health Care Center - Wealthy - 1900 Wealthy - Grand Rapids Department Name: Corporate Admin - Medication Care Coordination Employment Type: Full time Shift: Day Weekly Scheduled Hours: 40 Hours of Work: 8 a.m. to 5 p.m. Days Worked: Monday to Friday Weekend Frequency: N/A