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Navitus Health Solutions, LLC
US
Summary
The Access Specialist serves as a liaison between patients, providers, and insurance companies to facilitate access to specialty medications and financial assistance programs. They are responsible for investigating benefits, documenting patient information, and ensuring compliance with federal and state regulations.
Job Description
Company
Archimedes
Work Schedule Description (e.g. M-F 8am to 5pm)
Core business hours of 8-5, central
Remote Work Notification
ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
Hiring Manager : Full Name: First Last
Gretchen Lindlau
Overview
Under the direction of Supervisor, Specialty Pharmacy Services and pharmacists in the Specialty Pharmacy, the Access Specialist is primarily responsible for performing duties to assist patients with access to benefits, copay cards, patient assistance programs or foundations. The Access Specialist will work directly with patients, providers, insurance companies and manufacturers to review all opportunities for financial assistance for specialty medications. The Access Specialist may assist in the scheduling of delivery of prescriptions provided through the specialty pharmacy and assist any other area in the facility as needed with regard to pharmacy technician type duties.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
- Serve as the liaison between the pharmacy, insurance providers and patient in order to provide accurate and effective communications regarding financial assistance options and resources. All efforts aim to offer high touch quality, patient care
- Obtain, review and document patient demographics, medication history, and insurance status to identify socioeconomic barriers, opportunities for intervention and eligibility for prescription assistance
- Improve patient service experience through the provision of benefits investigations and conducting review of all opportunities for coverage of specialty medications
- Develop a thorough understanding of payer reimbursement and patterns for pharmacy claims with third parties
- Serve as a primary pharmacy resource to facilitate access to prescription medications. Including but not limited to; formulary/coverage issues, copay issues, patient assistance program eligibility, and other programs available
- Interact with external entities including but not limited to third party payers, manufacturers, prescription benefit management companies, external pharmacy personnel, and referring providers and their support staff
- Review complex insurance situations in order to educate patients, providers, and clinic staff on how to follow appropriate next steps to get access to prescription and medical benefit information
- The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee
- Other duties as assigned
Qualifications
What our team expects from you?
- Minimum High School Diploma or equivalent; Preferred Associate Degree in Health Science, Business or a related field
- National CPhT and/or registration/licensure required per employee’s residing state’s requirements
- One (1) year of experience in a healthcare, business, finance, or insurance related field preferred
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
Pay Range
USD $1,235.00 - USD $123,456.00 /Yr.
Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.
Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.
Founded
2003
Company size
1,001-5,000 employees
Industry
Hospitals and Health Care
Org type
Privately Held
Headquarters
Madison, WI
Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.
Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.
Founded
2003
Company size
1,001-5,000 employees
Industry
Hospitals and Health Care
Org type
Privately Held
Headquarters
Madison, WI