Pharmacy Care Coordinator

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Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career.

CHOP's Commitment to Diversity, Equity, and Inclusion

CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.

A Brief Overview
Responsible for obtaining prior authorization, facilitating patient access to medication, coordinating patient care to include documentation, dispensing and distribution under the supervision of licensed pharmacist meeting regulatory and accrediting agency requirements. The role will be responsible for medication authorizations to optimize patient access to their medication therapy. The Pharmacy Care Coordinator will also answer calls, handle verification and identification of covered and non-covered medications, explanations of benefits structures, as well as necessary follow-up with families, providers, and payors regarding referral issues, authorization questions, insurance eligibility issues, copay assistance programs, and medication delivery as applicable. The Pharmacy Care Coordinator will cross cover other areas as needed.

What you will do

• 1. Provides information of Pharmacy benefit structures to patients/caregivers, clinical team and physicians as well as perform the following responsibilities:
• Eligibility verification
• Authorizations
• Expected out-of-pocket costs and copay assistance programs
• 2. Introduces and explains scope of Pharmacy services to the patient/caregiver to include: medication history, refill coordination, access to emergent services, and pharmacist escalation as appropriate.
• 3. Provides customer service when answering incoming patient calls, communicating with patients on urgent requests, and communicating with medical/nursing staff to obtain key information needed
• 4. Assists with coordinating and scheduling the prescription delivery process.
• 5. Prepares new and refill prescriptions accurately, through the proper use of equipment and techniques, based on CHOP Policy for prescription entry and dispensing.
• 6. Participates in departmental process improvement initiatives.
• 7. Follows up with insurance companies and families of patients identified as ineligible or non-covered
• Contacts family and/or responsible party, as necessary, to inform them of any insurance problems or restrictions, ensuring that insurance information is clearly relayed to and understood by family and/or responsible party. Contact clinical office with all information that requires follow-up.
• 8. Performs other duties as assigned by Pharmacy Management.
• 9. Create and/or update patient record by verifying demographic, insurance information, or proper study identification in the registration system
• 10. Ensure specific registration fields are accurately inputted into registration system, including but not limited to visit notes, referral/authorization numbers, eligibility review, proper payor plan entries for research and standard-of-care visits
• 11. Verify coverage through third party benefit coverage/authorization vendors.
• 12. Educate and inform family of outstanding financial obligations if appropriate.
• 13. Electronically collect or facilitate payment of outstanding balances.

Education Qualifications

• High School Diploma / GED - Required
• Bachelor's Degree - Preferred

Experience Qualifications

• At least two (2) years relative job experience - Required

Skills and Abilities

• Ability to work with stressful situations
• Strong interpersonal, communication and organizational skills
• Ability to function efficiently and professionally with minimum of supervision.
• Ability to quickly learn new procedures.
• Strong computer skills.
• Ability to juggle multiple insurance issues.
• Strong customer service skills
• Ability to display compassion and empathy
• Mandatory required training within first 30 days:
• Website Insurance Training (Navinet, WebMD, Passport)
• EPIC training & testing (Prelude/Cadence).
• Registration Essentials
• Pharmacy systems training
• Pharmacy Insurance background preferred
• EPIC registration experience preferred
• Background in medical terminology preferred

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine. Learn more.

Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.

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