Job Description
Job Description Under direct supervision of the World Trade Center Health Program (WTCHP) Clinical Pharmacy Manager, this World Trade Center Pharmacy Benefits Coordinator interacts with patients, hospital employees, specialty pharmacy staff, medical/clinical staff, department managers, and clinics. External contacts include insurance companies on behalf of patient's medical and pharmacy benefits, pharmacies, NIOSH, and providers. These activities include supporting and interacting with patients, coordinating their prescriptions, and working with clinical staff to complete necessary third party (insurance) prior authorization requests (when applicable). They are primarily responsible for providing assistance to WTCHP patients and clinical team members by triaging pharmacy benefit questions.
Responsibilities Duties and Responsibilities:
1. Works closely with the WTCHP Clinical Pharmacy Manager, the WTCHP Pharmacy team, as well as other WTCHP team members to ensure patients achieve access to medications
2. Assists in the operational workflows including product overrides, prior authorizations, patient navigation, and scheduling as required for referred patients
3. Aids in quality assurance process on WTCHP pharmacy claims
4. Assists in answering pharmacy benefit questions.
5. Provides a high level of customer service by triaging medication access questions including medication rejections at point of sale
6. Escalates patient and provider concerns in a timely manner
7. Schedules appointments, monitors follow-ups and addresses no-shows
8. Ability to work collaboratively as a member of an interdisciplinary team, and establish and maintain effective working relationships with other healthcare professionals, practitioners, patients and families.
9. Makes recommendations on system improvements to streamline clinical review processes, participates in the implementation of such optimizations and takes a leading role in staff retraining, when applicable
10. Provides education on Program guidelines and coverage determination to interdisciplinary teams.
11. Other duties as assigned
Qualifications While the position is mostly remote, however, it is classified as hybrid. Candidates will need to live within the New York City Metropolitan area and be available to work on-site as needed. This is a Full-Time, Hybrid position, Monday ? Friday.
Basic knowledge of Excel, Outlook preferred
Ability to learn additional health system and PBM portals and tools
Education:
? HS/GED; Associate?s or Bachelor?s degree required
Experience:
- 2 years of pharmacy technician experience preferred
- Certification for pharmacy technician, required (or planned within 3 months of hire)
- New York State pharmacy technician, required (or planned within 3 months of hire)
- Retail pharmacy experience preferred
- 1 year of customer service experience preferred
- Experience with documentation in the electronic medical record preferred
Non-Bargaining Unit, 203 - HSO PHARMACY BENEFITS MANAGEMENT - MSH, Mount Sinai Hospital
About Us Strength Through Diversity The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai's unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:
- Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.
- Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.
- Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.
At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.
Explore more about this opportunity and how you can help us write a new chapter in our history!
"About the Mount Sinai Health System: Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's "Best Children's Hospitals" ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.
The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism."
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Job Tags
Full time, Traineeship, Local area, Remote job, Monday to Friday,