Pharmacy Resource Specialist

The Division of Pharmacy at MD Anderson Cancer Center strives to be the industry leader in providing premier patient-centered care, based on excellence and innovation in patient care, services, research and education.

We strive to ensure safe, effective and cost-conscious medication use and to work with our health care colleagues to promote optimal drug therapy outcomes through the development of integrated, quality programs.Analyze patient data to identify potential candidates for enrollment into Pharmacy Patient Assistance Programs and oversee and execute replacement drug orders.

• Obtain and verify information regarding patients enrolled / or attempting to enroll in vendor sponsored drug replacement programs
• Pre-screen patients by evaluating documentation (including Patient Financial Assistance (PAP) Applications, income documentation, proof of residency, etc.) to confirm potential candidates meet the qualifications set forth by vendor sponsored Patient Assistance Programs
• Submit required enrollment documentation to PAP for review
• Maintain accurate patient records/files
• Monitor pharmacy dispense reports and discerns qualified patients based on individual program criteria
• Compare medication administration records to physician orders to obtain correct dosing information
• Verify third party eligibility using tools provided
• Initiate replacement drug orders accurately and timely in accordance with the criteria set forth by the patient assistance program and validate the order was received by the sponsor
• Monitor submitted drug orders and verifies shipments are received by MD Anderson in a timely manner
• Reconcile replacement drug shipments received to orders placed
• Maintain drug replacement inventory records and updates records upon receipt
• Facilitate resolution of outstanding drug replacement issues timelyEnsure documentation and communication are provided in a timely manner.

• Document clear, concise and complete notes in appropriate system for each case worked
• Notify management timely on issues related to any and all job duties
• Use excellent written and/or oral communication and listening skills to establish and maintain effective working relationships with internal and external customers to include: pharmacy staff, physicians, nurses, social workers, patient account staff, insurance companies, reimbursement assistance program personnel and others, as necessary, to optimize patient assistance.Understand hospital billing processes and Accounts Receivable management.

• Analyze patient accounts to ensure pharmacy charges appear on the correct account in the hospital billing system
• Demonstrate a thorough understanding of patient accounts by analyzing payments, adjustments, or denials to ensure transactions are posted prior to requesting replacement drug or issuing drug replacement adjustments
• Initiate adjustments upon receipt of replacement drug to resolve patient balances according to policies and procedures set forth by Pharmacy Financial ServicesProvide oversight of Pharmacy Patient Assistance Programs and Audits.

• Create and maintain Standard Operating Procedures (SOP) for each PAP based on the criteria set forth by the program and internal department procedures
• Stay abreast of changes to institutional, departmental and program policies and procedures and updates SOP’s accordingly
• Provide team with updates when program requirements change at monthly team meetings
• Prepare for audits initiated by Pharma and/or internal audit by retrieving the requested documentation and preparing patient folders
• Evaluate patient files, identifies any potential deficiencies prior to the audit, and communicates findings to managementOther related duties as assigned.Education Required: Bachelor’s in Business Administration or related field.

Experience Required: Three years of pharmacy reimbursement, case management, managed care or insurance industry experience.

May substitute required education degree with additional years of equivalent experience on a one to one basis.It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law.

http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html WORKING CONDITIONS Frequency Deadlines Noise Patient Contact Physical Proximity Sedentary EnvironmentConstant 67-100%Constant 67-100% Constant 67-100% PHYSICAL DEMANDS Frequency Weight Arm/Hand Steadiness Carrying Eye/Hand Coordination Keyboarding Lifting Sitting Reaching Visual Acuity Constant 67-100% Frequent 34-66% Constant 67-100% Constant 67-100% Frequent 34-66% Constant 67-100% Frequent 34-66% Constant 67-100%Up to 5 lbsUp to 5 lbs COGNITIVE DEMANDS Analytical Ability Appropriate Behavior Attention to detail Comprehending Following Instructions Giving and Receiving Constructive Feedback Interpersonal Skills Memorizing/Remembering Multitasking Oral Communication Organizing Problem Solving Reading Skills/Comprehension Selective Attention Written CommunicationAdditional Information Requisition ID: 140135 Employment Status: Full-Time Employee Status: Regular FLSA: exempt and eligible for additional compensation for hours worked beyond your usual schedule, paid at a straight rate Work Week: Days Fund Type: Hard Pivotal Position: No Minimum Salary: US Dollar (USD) 44,000 Midpoint Salary: US Dollar (USD) 55,000 Maximum Salary : US Dollar (USD) 66,000 Science Jobs: No