Tallahassee, FL, US
12 days ago
Pharmacy Prior Auth Specialist
Welcome page Returning Candidate? Log back in! Pharmacy Prior Auth Specialist Posted Date 23 hours ago(9/11/2024 10:56 AM) Workplace Type On-site Job Location : City Tallahassee Schedule Days Position Type Full Time FLSA Status Non-Exempt Category Pharmacy Department Specialty Pharmacy ID 2024-16160 Company TMH WHO WE ARE & WHAT WE DO

Tallahassee Memorial HealthCare (TMH) is a private, nonprofit community-based healthcare system that provides advanced care to a 21-county region in North Florida and South Georgia. We are a career destination with nearly 6,000 colleagues who reflect the diversity of our community.  

TMH is the region’s healthcare leader and top provider of advanced care with a 772-bed acute care hospital and the region’s only: 

Level II Trauma Center Joint Commission Comprehensive Stroke Center Level III Neonatal Intensive Care Pediatric Intensive Care The most advanced cancer, heart and vascular, orthopedic & surgery programs in the Panhandle 

 

Our system also includes a psychiatric hospital, multiple specialty care centers, four residency programs and nearly 40 affiliated physician practices.  

HOW YOU'LL MAKE AN IMPACT

Your Role:

Verifies eligibility, obtains insurance benefits, and ensures pre-certification, authorization, and referral requirements are met prior to medication delivery.

Utilizes a proactive approach to ensure timely approvals facilitating high-quality patient care.

Manages prior authorizations and supports the 340B Drug Pricing Program.

Maintains documents and records.

Audits documents to ensure regulatory compliance.

Collaborates with healthcare providers, physicians, and clinical staff members.

Reports To:  

Prog/Specialty Pharm Mgr 340B (job code (JC): 221201)

Supervises:  

None  WHAT YOU’LL NEED TO APPLY

Required Education:

High school diploma or equivalent (e.g., certificate of high school equivalency).

Preferred Education:

Associate degree in Healthcare Administration, Business Administration, or other Healthcare field. 

Required Experience:

Two (2) years of Healthcare, Medical Billing, or related experience.

Preferred Experience: 

Retail of Specialty Pharmacy experience.

Required Certification/License/Registry:

Prior Authorization Certified Specialist (PACS) credential from the Accreditation Council for Medical Affairs (ACMA) within six (6) months post-hire.

Certified Pharmacy Technician (CPhT) credential from the Pharmacy Technician Certification Board (PTCB) or the National Healthcareer Association (NHA) within (6) months post-hire.

Preferred Certification/License/Registry:

340B Operations Certificate issued by Apexus.

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Tallahassee Memorial HealthCare is an equal opportunity employer and drug-free workplace. All employment is contingent upon successful completion of a drug screen, background check, reference verification, health assessment, and credential/license verification.  

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