Overview

Scope of Responsibilities: Provide guidance, assistance and expertise regarding specialty assistance programs between ProAct and contract pharmacies to include Noble Health Services and other specialty and/or retail pharmacies. Coordinate with all appropriate parties to secure funding assistance, medication shipment and regularly communicate updates on member-specific cases. Works under direct supervision and follows standard procedures to accomplish assigned tasks.

Job Summary: Responsible for coordinating functions related to specialty assistance programs to include, but not limited to ProActPLUS and other external copay sourcing program related operations on a day-to-day basis. Act as the liaison between ProAct, and Noble Health Services (or other network pharmacies) to support these programs and its components.

Responsibilities

Job Duties:

• Support ProAct clients and members regarding functions related to specialty assistance programs.

• Partner with Noble Health Services and other network pharmacies on the administration of ProAct-owned programs such as ProActPLUS as well as third party solutions and other utilization management programs.

• Perform outreach to physician offices and members to request prescriptions, confirm assistance components, etc.

• Process overrides in ProAct’s processing database to ensure claims are processing as intended after funding is secured.

• Assist Noble and other network pharmacies with various other ProAct-related inquiries or overrides that need to be entered for successful claim processing.

• Complete all mandatory KPH, state, and federal training programs.

• Perform other duties as assigned.

Qualifications

Experience Preferred:

• Preferred: 2 Years experience with Health Care, Insurance and/or Project Management

Special Conditions of Employment:

• Drug test

• Initial and continuous exclusion and sanction/disciplinary monitoring

• Any and all additional eligibility requirements based on the specific position

Required Training:

• HIPPA Privacy Course and CE Mastery Exam

• HIPPA Security Course and CE Mastery Exam

Job Requirements:

• Successful completion of a pre-employment and/or random drug screening test

Job Skills Required:

• Strong Communication Skills, must be able to effectively communicate both on the phone and in email setting

• Strong PC Skills, will be using multiple different PC programs

• Must be able to work independently

Behavioral Traits Required:

• Customer Service: Must provide timely and accurate responses to all business associates and customers

• Organization: Must organize work in a systematic way, establish clear lines of responsibility, and delegate effectively

• Communication: Must write and speak clearly and effectively at all levels, listen and be attentive to others

• Technology: Must use technology to its fullest potential to achieve department and corporate goals

• Flexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure

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Job Locations US-NY-East Syracuse, NY

Posted Date 5 days ago (6/17/2024 4:07 PM)

Requisition ID 2024-12753

# of Openings 1

Category Administrative/Clerical

Location : Location US-NY-East Syracuse, NY