Specialty Pharmacy Resume Samples

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D Powlowski

Daniela

Powlowski

786 Leda Mount

Houston

+1 (555) 370 1118

786 Leda Mount

Houston

Phone

p +1 (555) 370 1118

Experience Experience

Detroit, MI

Pharmacist, Specialty Pharmacy

Detroit, MI

Ryan Inc

Detroit, MI

Pharmacist, Specialty Pharmacy

Triages work flow in and between all areas, along with and if necessary in the absence of management
Performs all duties and functions in compliance with state and federal pharmacy laws and regulations
Performs Quality Assurance final verification of medications, information, and supplies, ensuring accuracy of patient order contents prior to dispense
Assists non - clinical employees by answering questions related to medication therapies
Supervises and educates pharmacy technicians ensuring Continuous Quality Improvement
Demonstrates competence in patient management, fulfillment, and clinical areas
Performs other duties as assigned within scope of practice

Los Angeles, CA

Specialty Pharmacy Program Manager

Los Angeles, CA

Yundt-Carter

Los Angeles, CA

Specialty Pharmacy Program Manager

Lead the planning, tracking and implementation of Specialty Pharmacy programs by serving as the business unit liaison with cross functional teams
Develops and implements standard operating procedures to ensure efficient delivery of products and services including billing and collections
Generates weekly detailed reporting and inventory reporting for manufacturer contracts
Liaison with the SP Customer Facing Team to gather insights from SPs, deploy programs, and monitor contract performance and quality
May manage vendor and service providers to define project scope and performance expectations. Incumbents maybe part of a project management office (PMO) in their business
Responsible for the management and growth of current products and ensure timely reviews, updates, and enhancement of existing programs
Serve as the primary point of contact for the Brand team for programs across all SPs on implementation of contracted programs, including operations and performance management

present

Dallas, TX

Regional Account Manager, Specialty Pharmacy

Dallas, TX

Macejkovic Group

present

Dallas, TX

Regional Account Manager, Specialty Pharmacy

present

Creates relationships with manufacturers
Make cold calls
Develop territory sales plan
High quality work, organized with attention to detail
Business Acumen-Specialty Medication and Therapy Management
Manage territory T&E and customer related expenses
Excellent communicator both verbal and written

Education Education

Bachelor’s Degree in Collaboration Across Account Teams

Iowa State University

Bachelor’s Degree in Collaboration Across Account Teams

Skills Skills

Strong attention to detail
Strong organizational and time management skills; keen attention to detail
General knowledge of reimbursement principles, pharmacy operations and medical claims
Strong mathematical skills
Strong interpersonal skills
Ability to work independently, within a team environment
Strong negotiating skills
Demonstrated proficiency with Microsoft Excel (intermediate level), Outlook and Word
Written Communications:Ability to communicate clearly and effectively in written English with internal and external customers
Strong attention to

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15 Specialty Pharmacy resume templates

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Specialty Pharmacy Testing Front Line Leader Resume Examples & Samples

Progressive work experience in an operational setting, with demonstrated supervisory experience
Applied knowledge of insurance processing and technical processes and practices
Associate’s or Bachelor’s Degree of Art or Science

Humana Specialty Pharmacy Call Center Manager Resume Examples & Samples

Provide guidance to a team of 8-10 frontline supervisors who manage day to day operational activities for their teams of approximately 150 front line associates
Identify issues and work with partners to identify / implement resolutions
Act as a liaison between call center operations and other functional areas
Identify and address barriers cross functionally that inhibit Humana Specialty Pharmacy from providing exceptional customer service
Provide ongoing coaching and feedback that enhances the contribution and performance of front line associates and leaders
Implementation of projects and processes that help solve complex organizational problems
Select competent and diverse talent to ensure best possible outcomes for customer service to members
Bachelors degree in Business, Finance, Operations or other related fields / or 10 years Customer Service Management experience
Operational experience in leadership role
Leadership experience over a large metric-intensive operational unit with a span of control between 80-200 associates
Certification in Six Sigma or Project Management
Prior Experience in healthcare or insurance setting

VP, Specialty Pharmacy Strategy Resume Examples & Samples

Develop personal/professional alignment with Humana’s Integrated Care Strategy – specifically, the commitment to lead and develop the Specialty Pharmacy team focused on the highest quality service and care for our members
Develop comprehensive knowledge of Humana’s Corporate Organization, the Healthcare Services Segment, the Group Segment, and the Retail Segment, and the interdependent service-driven relationships between these organizations that drives Humana’s success
Assume shared responsibility for the financial performance of Humana Specialty Pharmacy, including the development of a budget and strategic plan aligned with the Humana Pharmacy Solutions mission/growth objectives
Develop trust and credibility with cross-functional corporate and field-based leaders to maintain “One Humana” goals
Ensure linkages (upstream and downstream interfaces) between corporate, market based activities which regularly communicate Specialty Pharmacy initiatives, programs and decisions
Collaborate with several components inside the PBM to achieve many important strategies, including forecasting, research, analytics, network contracting, manufacturer contracting, and potential business development opportunities, among others
Regularly look forward into the future to innovate drug formulary, benefit design, bio-similar, and site of care strategies (among others)
Regularly assess current state of Humana Specialty Pharmacy against industry standards for productivity, quality, and cost. Partner with the field based sales organization to identify key markets of influence at a geographic and/or disease areas, amongst other dimensions
Recruit, select and develop a highly functional team dedicated to transformation of processes which impact Humana Specialty Pharmacy initiatives and programs. Provide the leadership necessary to maintain a motivated, productive and engaged team through open communication, rewards/recognition and delegation of responsibilities and authority
Act a progressive thought leader on Health Care Reform initiatives and Humana’s approach to improving our health care system; promote Humana’s mission to internal and external audiences
Lead a world class organization providing exceptional service, differentiating Humana as a preferred choice for “Integrated Care Delivery” nationally

Specialty Pharmacy Contracting Leader Resume Examples & Samples

Knowledge and subject matter expertise in the specialty pharmaceutical FDA approval process, specialty pharmaceutical manufacturer contracting, data service revenue fair-market-value determination, GPO class of trade differences, bio-similars, industry best practices and specialty pharmacy industry pricing benchmarks
Effectively manage Humana’s specialty pharmaceutical manufacturer relationships and contracting to ensure timely access to existing & new specialty products and to maximize cost of goods reduction & data service revenue opportunities
Collaboratively negotiate and execute specialty pharmaceutical manufacturer agreements with Humana Specialty Pharmacy, Corporate Legal and Corporate Procurement team members
Effectively manage the specialty pharmaceutical manufacturer contract review, negotiation and implementation process to ensure efficient and timely execution and implementation of contracts, terms and reporting
Track & communicate the progress and timeliness of the review, negotiation, execution and implementation of specialty pharmaceutical manufacturer contracts
Summarize and track specialty pharmaceutical manufacturer contractual agreement terms, obligations, pricing, data service revenue details
Develop and maintain reports & reporting systems to track, monitor, and report on Humana’s specialty pharmaceutical product access, prescription time-to-fill, purchases, pricing, cost of goods sold and gross margin metrics
Track and report on Humana’s and supplier’s contractual performance metrics (e.g. time-to-fill, reporting, accuracy, payment terms, etc.)
Monitor and report on Humana’s specialty pharmaceutical purchases, current pricing, DSR opportunities, cost of goods sold projections and gross margin metrics
Leverage price benchmarking and competitive bid mechanisms to ensure Humana’s specialty pharmaceutical pricing and data service revenue agreements are competitive across different sources of supply and pharmacy classes of trade
Work with Pharmacy Operations teams to facilitate specialty pharmaceutical supplier site visits and business reviews to discuss performance, product access, product pipeline and to maximize DSR opportunities
Manage day-to-day activities associated with Humana’s specialty pharmaceutical manufacturer relationships
Ensure the appropriate storage & team access to all Humana Specialty Pharmacy manufacturer agreements
Track and communicate industry trends and events that may impact Humana’s pharmaceutical supply chain
Maintain processes, methodologies and tools to forecast and model financial opportunities and communicate with stakeholders
Attend industry tradeshows and various manufacturer meetings at off-site locations or at Humana’s facilities
Bachelor’s Degree in Nursing, Pharmacy, Finance or Related Field
3-5 Years of Specialty Pharmacy Contracting, Pharmaceutical Industry or Pharmacy Supply Chain Work Experience
Intermediate or Advanced Proficiency in MS Excel, Access and Other Data Mining & Analysis Tools
Previous Specialty Pharmaceutical Contracting or Specialty Pharmaceutical Manufacturer Account Management Experience Preferred
PharmD, MBA or Nursing Degree Preferred

Humana Specialty Pharmacy Dispensing Clerk Resume Examples & Samples

High School Diploma or Equivalent
Ability to work around pharmaceutical products
Able to use material handling devices (pallet jack, hand carts, etc.)

Specialty Pharmacy Territory Manager Resume Examples & Samples

Previous experience working in sales with documented success
Flexible, dynamic personality who works well in a team environment
Must be comfortable with approx. 75% travel
Experience with Pharmacy reporting or the Pharmaceutical industry
Self-motivation
Exposure to pharmaceutical contracting language

Specialty Pharmacy Billing Technician Hmc Resume Examples & Samples

Review and screen new patients at intake to determine if patient has adequate prescription coverage. Refer appropriate patients to financial counseling for coverage or charity application
Provide customer service through the Specialty Pharmacy Call Center. Triage patient calls to appropriate party
Provide monthly adherence phone calls to patients
Contact Department of Health and caseworkers and patients with regard to missing documents for insurance plans
Work with financial counselors, HRSA, social workers, financial advocates and patients to monitor and review patients in spend-down or pending DSHS status. Review pending reports from pharmacy management system and rebill claims when coverage is granted
Troubleshoot and resolve billing rejections and subsequently rebill claims to appropriate carrier for all commercial, federal, and state insurance plans. Submit prior authorization requests, follow up on submitted prior authorization requests and submit claims with approvals as appropriate
Assist with prescription audits
Participate in the Specialty Pharmacy quality management program as part of the Specialty Pharmacy Committee
Establish and maintain good working relationships with billing operations specialists and Outpatient Clinic pharmacy staff to maintain effective communication regarding third-party billing issues
Educate pharmacy staff about third-party billing policies and procedures as needed
Assure that policies and procedures are followed in coordination with the Billing Operations Specialists, Leads, Manager and Director

Specialty Pharmacy Solutions Coordinator Resume Examples & Samples

Ensures an optimal prescription fulfillment service focusing on the coordination and scheduling of on time delivery, reporting, invoicing, ordering, data integrity and communication
Ensures accurate and timely coordination services activities in compliance with internal and external expectations
Communicates directly with pharmacies and other service providers to ensure the needs of the patients are met
Minimum of two years of related experience and/or on Customer Service
Technologically Savvy- knowledge of CRM databases a plus!
Demonstrate superior customer service skills
Exhibit a good understanding of ABS Canada services and client base
Strong verbal and written communication skills, interpersonal skills and attention to detail
Ability to make decisions using sound judgment and take initiative with minimal direction
Ability to work well within a team-based environment

Corporate Director, Specialty Pharmacy Resume Examples & Samples

Develops and manages all key Specialty Pharmacy operations, including, but not limited to: a) benefits verification b) referral and order entry c) pharmacy and medical coverage eligibility d) prior authorizations e) billing and collections f) dispensing and shipping g) purchasing and inventory control h) specialty therapy management and i) payor contract management
Interacts with the PHS Specialty Pharmacy Advisory Board and steering group. Meets with other organization pharmacy leaders, medical staff, and senior executives to assure that the Specialty Pharmacy is fulfilling the strategic goals of the organization and operations are being executed in accordance with organization’s policies
Manages an effective system of communication with each hospital entity. Builds and executes focused marketing and communication initiatives to help patients and physicians, recognize and easily utilize the services of Partners Specialty Pharmacy
Reviews, revises, and assures that Specialty Pharmacy policies and procedures comply with state and/or local regulations and meet the professional standards of accreditation organizations such as TJC, ACHC and URAC
Works with health plans, other insurers, pharmacy benefit managers, and other third party programs to coordinate Specialty Pharmacy and associated Disease Management Services, relevant provider fee schedules, dual coverage issues, and client reporting activities
Doctorate of Pharmacy (Pharm D)
Experience in operational leadership and team management within a specialty pharmacy and/or ambulatory pharmacy, particularly at an Academic Medical Center
Minimum of 5 to 7 years of experience with a proven track record of successful operational and financial leadership in the healthcare field
Eligible for licensure to practice pharmacy in the State of Massachusetts
Advanced Degree (i.e. MBA, MPH, MHA) or equivalent professional experience preferred
Demonstrated Pharmacy leadership and clinical experience
A demonstrated track record of improving operational efficiencies and achieving financial target goals
Strategic thinker with ability to translate into operating programs
Capable of interacting with multiple levels of an organization (Senior Leadership, MDs, etc.) and handling multiple complex situations simultaneously
Strong influencing and decision making abilities; comfortable in a consensus building environment
Strong business and financial acumen with prior experience managing budgets and profit and loss statements
Knowledge of specialty pharmacy reimbursement as well as payer and manufacturer contracting
Understanding of state and regional regulations; familiarity with the requirements of accreditation organizations such as TJC, ACHC and URAC
Knowledge of the health informatics business and value of orals data to bringing data solutions to interested constituents

Product Manager Specialty Pharmacy Resume Examples & Samples

Manages the product life cycle from the strategic planning perspective
Develops product enhancements based from the “voice of the customer” and is the expert on users and their requirements
Collaborates with end users to determine needs and requirements, as well as features, and functionality to meet their needs
Defines scopes, creates, and positions new products and existing product enhancements based on the company’s capabilities, competencies, and strategic fit to maximize sales revenue, market share, and profit
Drives and facilitates stakeholder consensus around scope and priorities where multiple opinions and needs exist
Responsible for determining the high-level requirements (epics/themes) that are part of the product roadmap and release plan in conjunction with other stakeholders
Works with Technical Product Owners to capture epics/themes for expansion by the team
Provides the expected benefits as part of initiative ROI analyses and helps the Service Lead prepare documentation necessary for investment approvals. Supports the development team in the effort to design the simplest possible solution to the business need
Works with non-acute business partners to create awareness of relevant Vizient offerings for Provista Sales
Work with support, sales and marketing to highlight the customers’ needs and wants
Minimum of BS degree in business related field of product development in field or related field preferred
Agile/Scrum experience
5+ years of software marketing and or product management experience
Knowledge of healthcare, GPO business and non-acute environment
Knowledge of pharmaceutical supplies and pharmacy operations
Ability to synthesize market and customer feedback and translate into new product solutions; comfortable with making trade-offs, decisively
Expertise delivering complex projects to meet demanding feature, cost, quality and introduction date targets
Demonstrable communication skills and ability to lead an organization to develop market leading products/solutions
Must be flexible with a “can do” attitude and have the ability to remain professional under high pressure situations
The position requires 25% travel within North America to current and potential customer sites as well as various industry events

Senior Mgr, Specialty Pharmacy Resume Examples & Samples

Provides strategic and tactical oversight and leadership to the specialty pharmacy team
Oversees the dispensing of medication to patients in a timely manner. Oversees staff regarding dispensing prescriptions, verifying written prescriptions, DUR and medication fulfillment
Oversees patient benefit investigations
Communicates with patients and physicians via phone, fax and email to resolve prescription issues and to assist in the prior authorization process
Ensure compliance for all state and federal regulations and guidelines as they pertain to specialty pharmacy
Creates financial reports and conducts audits through sales, AR and inventory reports. Performs revenue reconciliation and participates in CQI activity
Provides clinical expertise in patient consultation
Supports Marketing activity through script capture and customer retention data
Creates, implements and monitors department and individual metrics
Manages staff schedule and sets performance goals and objectives. Creates and conducts performance reviews
Determines and schedules after hours support
Performs special projects as needed.*LI-KM1
Preferred A Doctor of Pharmacy (PharmD)
Required 5+ years of experience in a licensed pharmacy role
Required 2+ years of management experience
Required Other Previous mail order pharmacy or home infusion pharmacy experience
Advanced Demonstrated interpersonal/verbal communication skills
Intermediate Other Ability to evaluate information and develop clear, concise and crisp reports
Intermediate Other Ability to use pharmaceutical and medical reference, literature to provide drug information to the health plan
Required Other Current unrestricted pharmacy license in state of operation
Preferred Other Consultant pharmacy license
Required Intermediate Microsoft Word Solid use of Microsoft products including Word, Excel, and Power Point
Required Intermediate Healthcare Management Systems (Generic)

Specialty Pharmacy It-call Center System Analyst Resume Examples & Samples

Lead requirements gathering, service-oriented modeling, analysis and design activities
Evaluate business requirements and prepare detailed functional and technical specifications
Communicate design to all stakeholders and varying levels of the organization
Present and evaluate design solutions objectively and facilitate conflict resolution
Define, use and communicate design patterns and best practices in service oriented analysis, design and development
Collaborate with quality assurance team to ensure testing efforts align with system deliveries and business processes
Responsible for supporting new development and enhancements of the Navigator application for the Specialty Pharmacy line of business
Bachelors Degree or equivalent work experience
3+ years of experience in Systems Analysis or IT Development
3+ years of experience in all phases of Software Development Life Cycle (SDLC) / System Development Life Cycle
3+ years of experience translating business requirements into a detailed system specification
3+ years of Relational Database experience

Specialty Pharmacy Sales Associate Resume Examples & Samples

Building relationships with physician’s offices that deal with complex chronic diseases such as Cancer, Hepatitis C, MS, Rheumatoid Arthritis, and Crohns Disease
Within your assigned territory use effective communication via phone, email, fax, and WebEx, to consistently move customers or prospects toward commitment of using BriovaRx as their specialty pharmacy
Associate's Degree or Higher
2+ years sales experience with documented success
Track record of over- achieving quotes
Strong phone presence and experience with cold calling
Ability to multi-task, prioritize, and manage time effectively

Regional Account Manager Specialty Pharmacy Resume Examples & Samples

Develop territory sales plan
Use consultative sales process, probe for customer information and barriers
Creates relationships with manufacturers
Close sales
Serve needs of medical practice accounts and solve issues
This is a commission eligible position
Business Acumen-Specialty Medication and Therapy Management
Excellent communicator both verbal and written
Easily builds relationships with outgoing personality
High quality work, organized with attention to detail
Customer focus
MBA or professional health care degree

Regional Account Manager, Specialty Pharmacy Resume Examples & Samples

Research and identify sales targets
Make cold calls
Develop creative solutions to gain profitable business
Manage territory T&E and customer related expenses
Travel 50% with occasional evening or weekend event participation
Good listener
Productive with good planning
Proficient use of Outlook, Word, Excel and Power Point
Business Acumen - Specialty Medication and Therapy Management
4 + years of experience in specialty pharmacy or medical device sales
Proven track record of sales success
Multiple Sclerosis, Autoimmune or Oncology therapy sales experience

Assoc Director National Accounts Specialty Pharmacy Resume Examples & Samples

Is responsible for complete business ownership of assigned essential Key Accounts; develops Account strategy and objectives in line with MC objectives; aligns Account strategy with other key Sales, Marketing, Medical and Managed Care functions and ensures cross-functional support
Leads negotiations, contracting, pull-through and distribution management with assigned Accounts
Delivers the Account plans and required financial results for own Accounts; works effectively with colleagues in other functions to achieve Account sales. Liaison with Specialty Products’ Brand and Sales Team
The position requires a strong working knowledge of both the practice and business of specialty pharmacy
Collaborate with Product BU to develop and utilize the correct programs for each situation
Communicate reimbursement and payor issues affecting Specialty Products in accordance with company policies
5+ years of account management experience with managed care, specialty pharmacy, institutional accounts experience
5+ years of managed care contracting experience

Specialty Pharmacy Inside Sales Associate Resume Examples & Samples

Build relationships with physician’s offices that deal with complex chronic diseases such as Cancer, Hepatitis C, MS, Rheumatoid Arthritis, and Crohns Disease
Within your assigned territory, use effective communication via phone, email, fax, and WebEx, to consistently move customers or prospects toward commitment of using BriovaRx as their specialty pharmacy
Work closely with Manager and Director of Sales to determine best plan of action for top accounts in your territory
Establish relationships with pharmaceutical manufacturer reps in your territory
Utilize territory pipeline and all BriovaRx sales/marketing tools, territory data/reports to successfully grow your book of business and achieve stated goals
Uphold the highest ethical standards, comply with all UHG and government policies and regulations
Demonstrated success in identifying problems and proposing solutions for clients or customers
Proven track record of success against quotas or performance goals in a prior role
1+ year’s sales experience with documented success
Experience with cold calling via phone or in-person
Professional phone presence with exceptional verbal communication skills
Ability to build trust and relationships over the phone
Enthusiastic, agile learner, driven to succeed

Senior Product Manager, Specialty Pharmacy Resume Examples & Samples

Business owner for therapeutic categories and leader of cross-functional work groups
Lead cross-functional work groups to identify and execute strategic enhancements for multiple therapeutic categories
Monitors business, P&L, gross margin, EBIT, market share and growth forecasts
Extensive data analysis to monitor and drive the business
Evaluates the service model and optimizes patient experience
Manages work plans for project execution and implementation
Responsible for all stakeholders as it relates to product development and programs at the specialty pharmacy (payer, patient, physician, Pharma)
Works with Clinical team, Pharma Account Management & contracting teams to develop new programs, revenues, and build relationships with key pharmaceutical manufacturers
Leads Therapeutic Resource Center (TRC) Workgroups with Operations, Pharma Acct. Mgmt. and other key partners
Develops marketing campaigns and tools for key segments (patient communications, physician communications, web, search engine marketing, etc
Bachelor’s degree in related field or equivalent work experience; Master’s degree preferred
8-12 years of relevant work experience or Master’s degree with 5-10 years of experience
Excellent communication skills, including presentations and documentation
Data analysis and reporting skills
Basic financial analysis skills
Demonstrated ability to prioritize and manage work load and meet project deadlines
Ability to work towards specific deliverables within a environments of tight deadlines and significant pressure
Ability to handle complex analysis from issue identification to proposal of potential solutions
Excellent customer service skills required
LI-AL1

Regional Account Manager, Specialty Pharmacy Resume Examples & Samples

4-5 years’ experience in pharmaceutical sales, or specialty pharmacy sales required
College degree, MBA or professional health care degree
Fertility, RSV, Growth Hormone, or Hepatitis C sales experience

Specialty Pharmacy It-lead System Analyst Resume Examples & Samples

Serve as the liaison between business and systems analysts, developers and project management groups
Develop strategies to improve service development life cycle and governance processes
Develop detailed source-to-target data mapping and data transformation rules
Develop and use enterprise service and data models
Responsible for supporting new development and enhancements of the ScriptMed pharmacy system
Bachelor’s degree in Math, Statistics or Computer Science, or High School Diploma / GED with 5 years in the IT field
5+ years of experience in Systems Analysis or IT Development
5+ years of experience in all phases of Software Development Life Cycle (SDLC) / System Development Life Cycle
5+ years of experience translating business requirements into a detailed system specification
Proficiency with MS Project, Word, Excel, Visio, PowerPoint
2+ years of Relational Database or SQL Experience
Must be able to manipulate large sets of data
Experience with advanced relational databases and query tools
Possess strong analytical, organizational, presentation and problem solving skills
Proficient in report writing and query skills such as SAS, and various word processing, spreadsheet, graphics, and database programs including Microsoft Word, Excel, Access, PowerPoint, Outlook, Visio etc
Health care experience
Experience working with test plans and test cases
Experience facilitating Joint Application Design (JAD) sessions
Experience working in an Agile environment or familiarity with Agile methodology
Specialty Pharmacy or other Pharmacy experience

RN Case Manager, Specialty Pharmacy Resume Examples & Samples

Making outbound calls to assess members' current health status
Identifying gaps or barriers in treatment plans
Providing patient education to assist with self-management
Educating members on disease processes
Encouraging members to make healthy lifestyle changes
Documenting and tracking findings
Making calls to patients to ensure understanding of disease state, prescribed medication regimen, and how to manage current disease state and treatment protocol
Reviewing medical records for documentation in order to qualify for prescribed treatments
Educating and supporting the individual through telephonic assessment and expert clinical case management interventions
Active, unrestricted RN license in the state of Texas, and the ability to gain licensure in other states as requested
3+ years of clinical nursing experience with adults
Intermediate / proficient level of experience with MS Office applications
BSN
Experience in managed care, case management and / or disease management
Experience working with patients in the following settings and/or patients affected by any of the following disease states: Emergency Department, G.I., Oncology, Multiple Sclerosis, Auto-Immune Disorders
Knowledge of disease processes for chronic illnesses in the adult population
Experience with Prior Authorizations and/or Appeals

Humana Specialty Pharmacy Customer Care Specialist Resume Examples & Samples

Proficiency with a computer including Microsoft Office Programs
Must be available to work any shift from 8:00 am - 8:00 pm Monday- Friday and 8:00 am - 6:00 pm on Saturdays
Excellent written and verbal communication
At least one year of customer service experience

Specialty Pharmacy Representative Resume Examples & Samples

Present therapeutic products and creatively teach people about their usage
Build trust and credibility and become a true collaborator in commercial success
Strong sales and relationship building skills
Proven business acumen and a working knowledge of applied science
Ability to travel and possess a valid driver's license to drive toassigned healthcare accounts, unless otherwise specified

De-specialty Pharmacy Representative Resume Examples & Samples

Call on Infectious Disease and GI physicians to advocate the usage of our client's specialty pharmacy
Maximize new business opportunities with physicians and other health service providers
A relevant bachelor's degree, ideally in a life sciences field
The drive for self-development, the ability to collaborate and an action-oriented work ethic

Specialty Pharmacy Patient Business Associate Resume Examples & Samples

Obtain detailed insurance benefit information including but not limited to; appropriate billing information (medical vs prescription covered benefit) retail and mail order prescription co-pays, network pharmacies, plan formulary, prior authorization requirements, and other necessary information to successfully adjudicate a specialty medication claim
Evaluate patients medication, insurance, and financial situation and counsel them regarding their prescription insurance coverage, benefits, and related requirements, as well as the resources available through various channels (insurance, drug manufacturers, charity care, etc) to ensure affordable access to specialty medications
Ability to train, share knowledge and expertise with colleagues, and develop and implement process improvements
Evaluate medication orders to determine appropriate interventions, including prior authorizations, appeals and financial assistance
Assist patients with the necessary documentation needed to apply for extra help, charity care, manufacturer drug assistance, Medicaid, and/or other qualifying insurance or assistance programs. Maintain regular contact with patients to ensure smooth and timely transition into these programs, with minimal to no interruption in therapy
Proactively monitor patients insurance for changes in benefits and coverage, update billing information in appropriate systems when necessary, and maintain consistent communication with the patient as needed
Contact patients with outstanding pharmacy balances and facilitate payment arrangements
Document all patient interactions in appropriate systems and databases, including MiChart, TheraDoc, Otis and QS1
Stay abreast of current regulations and requirements of insurance companies, assistance programs and other medication resources
Act as a resource and effectively communicate complex insurance and financial information associated with specialty medications to all areas within the medical center including clinics and providers as well as insurance companies, patients, and their families. Participate in patient education programs, including group classes and one on one teaching
Facilitate patient enrollment or transition to a non-UMHS pharmacy when needed based on patients? insurance requirements to ensure uninterrupted access to their specialty medication
Candidates should have an associate degree in a healthcare-related field and/or experience in a pharmacy or medical office setting with strong background in insurance benefits, billing and verification, and patient financial counseling. Candidates with an equivalent combination of 3-5 years of education and/or experience may be considered
Bachelor's degree is preferred

Manager, Specialty Pharmacy Ops Resume Examples & Samples

3+ years experience supervising staff
Experience working as part of a collaborative team
2+ years in operational management
ETASU and REMS experience
Experience working with multiple departments
2+ years experience with process improvements
Experience managing other pharmacy staff

Pharmacist, Specialty Pharmacy Resume Examples & Samples

Supports inherent leadership and supervisory role for technicians and non - clinical employees
Performs Clinical review of prescription orders for basic appropriateness of therapy or plan specific criteria review i.e., Prior Authorization
Verifies patient orders for completeness and accuracy before being sent to fulfillment i.e., prospective DUR including allergies, interactions, contraindications, etc
Counsels patients according to OBRA 90 standards and answers patient questions about medications
Accepts physician calls for new prescriptions or questions about our services or Specialty medications
Effectively utilizes clinical tools
Transfers prescriptions in and out and to other pharmacies as appropriate
Supervises and educates pharmacy technicians ensuring Continuous Quality Improvement
Maintains applicable pharmacist licensure(s) including necessary Continuing Education requirements, without lapse (any lapse excludes pharmacist from practicing pharmacy)
Current, unrestricted Pharmacist license in the state of Florida
Minimum 1 year of specialty, community, retail, hospital, or long term care pharmacy experience
Presentation, facilitation and / or training experience

Data Manager, Specialty Pharmacy Resume Examples & Samples

Gather, consolidate and track all Patient Hub, Specialty Pharmacy, Prescriber, Plan, Payer data. Validate that data being reported and analyzed is of high quality before being delivered to various internal teams
Define & maintain data governance and reporting standards with data aggregator, Specialty Pharmacy and Hub service providers to ensure meaningful and standard set of data feed codes
Manage the data intake from various data vendors to the Valeant internal reporting platforms
Establish SOPs for how to collect, store, and analyze data, especially how to evaluate data completeness, timeliness and accuracy with suppliers
Partner with internal teams to develop reporting templates and metrics to track and measure key performance indicators
Responsible for creating business reviews documents & management reports to ensure services provided by accounts are consistent with terms of agreements
Work with Specialty Pharmacy Account Management, Field Reimbursement Team and other intenal teams to ensure understanding of the data
Provide insights on the patient journey & throughput bottlenecks across Hub and Specialty Pharmacies
Ensure compliance with regulatory rules including HIPAA policies across 3rd parties

Specialty Pharmacy Sales Account Executive Resume Examples & Samples

Submit paperwork and perform administrative tasks in a timely manner
Partner with Marketing to design educational tools and presentations for a variety of audiences (i.e. patients, physicians,)
Advanced presentation skills to a variety of audiences (size, education levels, roles and responsibilities)
Advanced computer skills in MS Word, Excel, PowerPoint and Outlook
Ability to travel extensively (up to 80%) throughout Nevada and New Mexico
Demonstrated proficiency in consultative skills when addressing complex inquiries from physicians, teammates, vendors, and customers
Valid driver’s license in state of employment; driving record must meet insurance liability

RN Supervisor of Case Management Specialty Pharmacy Resume Examples & Samples

Supervises their assigned staff in all aspects of the position, including, but not limited to, monitoring of workload, quality assurance, staffing, work assignments, management reports, maintaining account profiles and training
Manages each case manager productivity, team work, and revenue on a daily / weekly / monthly basis and as needed
Trains new staff
Assures their assigned staff are following procedures per account protocols and departmental policy and procedures and meeting all time frames required
Assists their assigned staff with difficult cases and provides direction with strategy as needed
Performs reviews with their assigned staff every 30 days or sooner if needed
Works directly with the leaders of specialty pharmacy
Reviews their assigned staff’s clinical documentation to assure quality of work performed
Performs ongoing formal and informal reviews of staff and communicates goals, progression and areas for improvement with staff
Assures adherence to statutory regulations, HIPAA compliance and department policy and procedures
Trains and educates staff continually regarding work assignments, new program or existing program changes, and changes in policies, procedures and laws etc
Performs other activities as directed by the Director or Case Management Manager
Must have a valid unrestricted RN license and be able to obtain licenses in additional states as requested
Excellent communication, organizational and computer skills
Prior supervisory experience or demonstrated leadership skills
Call center or telephonic nursing experience
Bachelor’s Degree relevant to area of responsibility or closely related field
Demonstrates the ability to meet people comfortably, and build rapport conducive to effective work relationships
Is appropriately outgoing and assertive
Understands the agendas and perspectives of others; recognizes and effectively balances the interests and needs of one’s own group with those of the broader organization
Demonstrates self-assurance in own ideas, judgment and capabilities
Develops and implements cost saving measures; contributes to profits and revenue
Looks for ways to improve and promote quality; demonstrates accuracy and thoroughness
Coordinates own work efforts; understands and applies procedures, practices and department standards
Manages time effectively; handles multiple demands and competing priorities
Ability to multi-task; responds and reacts to a variety of critical issues simultaneously

Specialty Pharmacy Home Delivery Resume Examples & Samples

Manage a team of Specialty Pharmacists creating a culture of highly engaged Specialty Pharmacy employees
Provide clinical leadership for the Pharmacist team
Collaborate with our team of nurses to support the clinical needs of our customers
Drive process improvements to increase the clinical value that we provide to our customers and to the health professional community
Support strategic initiatives to drive improved service, growth, health improvement, and other strategies as defined
Licensed Pharmacist active with no restrictions
1+ years of management/leadership experience required
Pharmacy Benefit Management (PBM) experience preferred
Excellent communication, interpersonal and negotiation skills
Proven abilities in conflict resolution, coaching, developing, organization, prioritizing and problem solving are also essential to this position
Proficient in basic computer skills
Ability to adapt and be flexible within a fast and dynamic environment

Manager, Local Specialty Pharmacy Resume Examples & Samples

Ensures that store personnel provide hospitable service and information; and are courteous, friendly, and efficient
Responds to customer inquiries and complaints, maintains and improves overall image of pharmacy department. Responds to special needs of customers, as requested
BS in Pharmacy or Pharm D Degree from an accredited educational institute, and at least three years directly supervising pharmacy operations
Current pharmacist license in the states within the district (or willing to obtain within 1 year) per district guidelines. Must maintain active license
At least 4 years of experience planning, developing, and managing departmental expense and capital budgets
At least 3 years of experience directly managing people, including hiring, developing, motivating, and directing people as they work
Experience with client resolution and exposure to Specialty Pharmacy
Experience supervising or staffing of local specialty pharmacies

Specialty Pharmacy Inside Sales Associate Resume Examples & Samples

Associate's Degree (or higher)
The ability to create, save, and edit in Microsoft Word
1+ year of sales experience with documented success

Associate Director National Accounts Specialty Pharmacy Resume Examples & Samples

7-10 years of experience in the pharmaceutical/healthcare industry
5+ years of account management experience with managed care, specialty pharmacy, and institutional accounts experience
5+ years working with specialty product related medical practice, insurance and managed care, pharmacy practice, competitive business practices, competitive product knowledge, as well as commercial and government payer reimbursement issues

Marketing Intern BB Specialty Pharmacy Team Resume Examples & Samples

Supporting the development of a metric-based marketing plan
Building exclusive sales materials that deliver on a surround-sound marketing plan
Partnering with Sales Ops and Training to develop appropriate training tools
Influencing and building consensus with peers and business partners

Account Executive, Specialty Pharmacy Resume Examples & Samples

Attend team meetings, phone conferences, and training as needed
Utilize multiple technology platforms to manage accounts
Follow expense guidelines and budgets
Work with cross-functional teammates to build the right service and fulfillment model
Maintain current knowledge of DaVita Rx Pharmacy services and benefits
High Contribution to the rest of the account management Team through sharing successes and BDPs, Innovating, and Utilizing Creativity to drive unique business solutions
Dedication, above all, to caring for patients suffering from chronic disease across the nation
A minimum of 3 years prior Sales experience with Physicians that specifically provide Oncology, Gastroenterology, Rheumatology, Hematology or Neurology care as primary customer, prefer 5 plus years
A proven record of consistently Exceeding Sales Quotas
Professional presence and excellent presentation skills
Strong analytical proficiency in Excel, PowerPoint required
Strong written, verbal, and interpersonal communications skills including ability to listen attentively and to communicate information clearly and effectively
Ability to travel extensively (up to 80%) throughout the Los Angeles area and intermittently to Los Vegas, Albuquerque and to corporate functions
Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians and others in everyday performance and interactions
Demonstrated salesmanship ability and ability to influence others
Exceptional client relationship management and people skills

Clinical Program Manager Specialty Pharmacy Informatics Resume Examples & Samples

Maintain and update the Specialty Pharmacy Classification Policies
Provide guidance, decisions and execution on specialty drug list decisions for Argus process including weekly FDB/Medispan clinical oversight and decisions
Provide guidance, decisions and support to the clinical operations team on specialty drug catalogue decisions during the Codeset meetings and submits Specialty Pharmacy Codeset change ticket requests
Provide guidance and maintain all specialty drug lists (impacting the pharmacy and medical benefits) including utilization management (UM), Specialty/Optional/Medical lists, Exclusive SRx Home Delivery, clinical edits, business and client reporting, URAC compliance, Therapy Management, HealthEview, RxSavings Messenger and other customer decision tools
Identify lists and processes that could be migrated to the drug catalogue process, drive prioritization, and manage these lists during decision and migration timeframes
Assure consistency of drug list designs across medical and pharmacy benefits and claim engines
Develop and implement process to document and archive all Specialty Drug list decisions
Assists in establishing affordability and health improvement goals at a condition/therapeutic class level within Integrated Clinical Scorecard, KPI’s and long term business plan
Provide guidance to clinical program manager team members and Informatics team on identification of drug codes and other relevant clinical information for analytical purposes
Participate as a subject matter expert in the Therapeutic Class Strategy process, including design and decisions related to Utilization Management, Therapy Management, and Specialty fulfillment
Serve as client facing specialty pharmacy clinical expert as needed by Go To Market team, including client and RFP/RFI comparisons of drug lists, UM, and clinical programs across pharmacy and medical benefits
Primary liaison and subject matter expert with clinical operations, Pharmacy Criteria Council, and Pharmacy Service Center operations teams
Develops and maintains appropriate specialty pharmacy clinical program design and results documentation for internal and external use
Co-develop policy and procedures that govern clinical program operation
Bachelor’s degree in Pharmacy required; PharmD preferred
Intermediate knowledge of Microsoft Office applications including Excel and Access and preferable SQL coding capabilities required
5+ years of experience in Specialty Pharmacy with a Pharmacy Benefit Manager (PBM) or health plan required
Strong knowledge of PBM, Specialty Pharmacy and Health Plan business model required
Strong knowledge of drug coding standards and medical claims (HCPC) coding standards required
Proven capabilities in operational execution and decision making
Proven program implementation and oversight skills
Demonstrated ability to work in a highly matrixed environment
Creative thinker with strong organization and planning skills
Positive and team-oriented attitude and approach to getting work done
Proven ability to execute in fast paced, complex environment

Specialty Pharmacy Strategic Clinical Program Manager Resume Examples & Samples

Therapeutic class reviews of all specialty medications, holistic financial and clinical integration reporting
Development of patient and physician outreach programs to ensure appropriate use, compliance, and outcomes
Identification and review of Pipeline medications, proactive strategies to address formulary positioning and rebate opportunities
Liaison between Contracting team and Specialty Pharmaceutical Manufacturers, evaluation of traditional and value based rebate opportunities
Integration into and representation at Enterprise Specialty Strategy Team, responsible for launching corporate wide direction within the Medicare Business
Channel optimization related to filling of Specialty Medications
Physician liaison and Specialty subject matter expert, participation in integrated benefit design
Ability to evaluate emerging industry trends and benchmark against internal results
Establishes practical, executable, measurable, and financially viable plans of enhance the profitability and accuracy of the Part D product
Utilizes financial economic expertise to calculate program ROIs
Bachelor’s degree in Pharmacy required; PharmD highly preferred
Extensive Medicare knowledge, with specific acumen in Medicare Part D, highly desired
Minimum 5 year’s experience in the healthcare industry, health plan or pharmacy benefit management (PBM) highly preferred
Minimum 5 years experience working with/in analytics. Ability to mine and analyze extremely large data sets of pharmacy claims
Proficiency with MS Excel and Access required
Demonstrated ability to work in a highly matrixed environment, high degree of emotional intelligence and interpersonal savvy. Self-starter and ability to work independently and autonomously
Strong presentation skills, written/verbal proficiency
Ownership of Specialty Pharmacy Strategy or benefit administration
Current or previous people leadership experience
Valuation of large scale Strategic Initiatives
Experience building tools and automated solutions
Ability to expertly utilize SAS for data mining

Specialty Pharmacy Liaison Resume Examples & Samples

Lead and facilitate daily conference calls with specialty pharmacy contacts (and client, if applicable) to monitor patient progress, reconcile data discrepancies, research missing data, handle inquiries and provide updates as requested
Coordinate and process copay requests including but not limited to patient status requests, copay assistance, prior authorization and billing inquiries and obstacles, eligibility inquiries, and claims processing challenges
Create and maintain action log, agendas and minutes for each specialty pharmacy meeting
Handle inbound/outbound calls from all applicable customers including but not limited to specialty pharmacy contacts, client contacts, third party vendors and internal team resources
Triage and/or approve referrals to specialty pharmacies daily or as needed
Reference and implement Business Requirements Document (BRD) as it pertains to operating procedures, validation of incoming data from the Specialty Pharmacy, and identifying and escalating data feed issues internally and externally
Identify needed system enhancements and/or reports and participate in requirement review, testing and implementation
Implement business requirements for newly-contracted specialty pharmacies joining the network to ensure adherence to all contractual obligations; ensure all data is validated prior to program launch
Coordinate data transfer with client and ensure data integration during transition of product support services from another HUB provider
Share best practices and learning opportunities with reimbursement team
Identify and report Adverse Events
Strong negotiating skills
Strong mathematical skills
Strong organizational and time management skills; keen attention to detail
Ability to work independently, within a team environment
General knowledge of reimbursement principles, pharmacy operations and medical claims
General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred
Global understanding of commercial and government payers preferred
Demonstrated proficiency with Microsoft Excel (intermediate level), Outlook and Word

Director, Specialty Pharmacy Solutions Resume Examples & Samples

Implements SP specific segment strategic and tactical sales plans to support corporate goals; utilizes the AmerisourceBergen consultative sales approach of uncovering customer business needs and creating ABC solutions to fit those needs
Manages assigned key SP segment accounts to deliver the targeted Gross Profit to ABDC, as well as an excellent customer experience
Drives new business with targeted SP segment large/national prospects and consults with the CSP National New Business and District Teams on High Value and Small targeted prospects/opportunities
Implements and executes the assigned SP segment specific GPO value proposition and sales strategy; ensures the CSP National New Business and District teams are fully informed
Builds and manages relationships with both the CSP National New Business and District sales teams; as well as ensuring strong and productive ongoing relationships with key ABDC functional leadership
Consults with assigned and CSP District team SP customers to create profitable business strategies taking into account such factors as customer’s vision and goals, current results by category/program and compliance with ABC programs and services
Develops and implements strategic/tactical sales and marketing plans to accommodate ABDC business goals within assigned SP segment accounts
Determines and executes the SP account specific value proposition and sales strategy; identifies resources; operates as the single point of contact in new strategic opportunities
Gathers information, analyzes and develops strategies concerning dynamics that may affect area of responsibility, such as changes in customer ownership, new affiliations, current market share and targets of opportunities for new growth, customers’ changing requirements, competitor strengths and weaknesses, and continually communicates these strategies internally using updates to written business plans and ongoing business communication
Requires broad training in fields such as business administration, accountancy, finance, sales, marketing, or similar vocations generally obtained through completion of a four year bachelor’s degree program or equivalent combination of work experience
Normally requires a minimum of six (6) years directly related and progressively responsible experience
Specialty pharmacy sales experience highly preferred
Strong consultative selling skills
Experience at building and executing strategic account penetration plans
Orchestrates organizational resources
Excellent Organizational & Project Management skills
Demonstrated value-based sales record
Working knowledge of pharmaceutical distribution with emphasis in specific Specialty Pharmacy segment sales and healthcare trends
Working knowledge of sales management, sales planning and goal setting, successful strategic and consultative selling techniques, and related information
Ability to lead large, value-driven pursuits
Strong leadership skills

Specialty Pharmacy Liaison Resume Examples & Samples

Excellent active listening and written/verbal communication skills required to
Quickly and accurately understand the need of callers seeking information
Provide responses that address the specific needs of each caller, while complying to Alkermes program and compliance guidelines
Document call details with attention to data integrity for analysis supporting business objectives
Ability to multi task, problem solve and work independently
Effectively plan, prioritize, execute, follow up and anticipate problems
Manage multiple projects in fast-paced, deadline driven environment
Work collaboratively across multiple stakeholder groups
Prior reimbursement experience with ability to communicate complex reimbursement scenarios and solutions to patients and medical professionals
Demonstrated ability to work collaboratively in a team environment and as an independent contributor
Ability to think critically and problem solve to address customer needs and barriers to product fulfillment
Ability to support programs needs as necessary
Accommodate approximately 15% overnight travel for
Bachelor’s degree preferred
Minimum of 3 years’ experience working in a reimbursement hub supporting products distributed by a specialty pharmacy, time working in specialty pharmacy operations, or for an aggregator of specialty pharmacy data
Experience implementing and supporting electronic data exchanges between a reimbursement hub program, and specialty pharmacy
Knowledge of health plan reimbursement requirements for specialty injectable products covered by both medical (AOB) and pharmacy benefits
Working knowledge of the compliance and regulatory environment for manufacturers in the pharmaceutical space
Experience and understanding the importance of reimbursement hub metrics and operations in the pharmaceutical industry
Proficiency in Microsoft Outlook, Word, Excel, and Power Point
Program /product launch experience a plus

Manager, Specialty Pharmacy Resume Examples & Samples

Supervises the activities of pharmacists and support staff assigned to the store; ensures accurate and timely preparation and processing of orders and computer operations
Assumes responsibility for safe and accurate handling of all funds and records
Reviews and interprets all physicians orders for processing, rationality, dosage form, allergies, interactions, incompatibilities, etc.; advises prescribing physician of inconsistencies and recommends alternate medications; determines proper quantities to be prepared/dispensed
Provides drug information to physicians, nurses, patients, and other appropriate individuals by consulting with physicians regarding any and all drug therapy requested; clarifies physician orders and assists physicians in investigating new and alternate medications to be used; performs drug information research as needed; participates in drug studies and research
Instructs patients regarding individual mediation therapy
Enters patient and medication order information into pharmacy computers to facilitate medication dispensing, and utilizing computer as a drug information resource
Coordinates the third-party prescription process by ensuring accuracy of information to include patient name, physician provider numbers, product name or NDC number, directions, directed daily usage and corresponding quantities
Supervises personnel functions and analyzes work flow and adjusts scheduling as needed
For specialty pharmacy: develops clinical documentation standards as required by URAC and other internal and external regulatory groups and customers
Develops integrated team and individual goals tied to overall specialty pharmacy goals
Adheres to direct report payroll budget and other budget areas defined by Senior Director
MS Residency may substitute for required experience

Specialty Pharmacy Liaison Resume Examples & Samples

Provide consistent and effective
Bachelor’s Degree and
0-2 years of experience or 6-8 years relevant working experience
2 years experience in
Proficient in
Ability to handle a
Advanced problem
Strong attention to
Research, analysis,
Demonstrated customer

Assistant Manager, Specialty Pharmacy Resume Examples & Samples

Ensures adequate staffing of these areas
Reviews daily, monthly and other periodic management reports to monitor service levels
Plans, develops, and manages all policies and processes related to technical pharmacy operations
Provides Manager with timely feedback regarding operational issues to ensure efficient workflow

Specialty Pharmacy Program Manager Resume Examples & Samples

Responsible for the management and growth of current products and ensure timely reviews, updates, and enhancement of existing programs
Evaluate complex medical information related to specialty pharmaceuticals and work with internal partners around program requirements, consultation, and feedback related to specialty management
Assist in the creation and execution of product plans to meet growth initiatives, identification of new product enhancements, operationalizing, and measuring specialty programs and management of relationships with strategic partners and key internal stakeholders
Bachelor’s degree and minimum of 8 years work-related experience, or
Master’s degree and minimum of 6 years work-related experience, or
10 years of equivalent work-related experience

Specialty Pharmacy Program Manager Resume Examples & Samples

Responsible for the coordination and completion of projects across various functional areas. Typically, employees in this function are working towards or have achieved certification in project management
Makes presentations to management on project updates, project cycle, and expected results. Ensures projects are completed on time and in scope
May manage vendor and service providers to define project scope and performance expectations. Incumbents maybe part of a project management office (PMO) in their business
Project Management roles specific to a particular functional area should be assigned to that family where appropriate (e.g. IT Project Managers should be placed in the IT Family)
Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.Analyzes and investigates
Bachelor Degree (or higher) in Accounting, Finance, Business or related field or HS Diploma/GED with 4+ years of professional Project Management experience
2+ years of project management experience
2+ years’ experience in tracking, planning projects, working with large data sets and making data-driven analytical decisions
Ability to communicate ideas clearly and concisely
Ability to prioritize and balance multiple priorities and projects

Specialty Pharmacy Services Resume Examples & Samples

Provide ongoing performance updates throughout the year
Counsel and administer disciplinary action in accordance to department and Human Resource policies
Address questions and concerns from the team
Provide individual and department training,mentoring and motivation to support and improve performance

Specialty Pharmacy Liaison Resume Examples & Samples

Bachelor’s Degree and 0-2 years of
2 years experience in a customer
Ability to handle a fast paced
Strong team building skills and
Research, analysis, report
Demonstrated customer service

Specialty Pharmacy Liasion Resume Examples & Samples

Provide consistent and effective communication to all appropriate stakeholders as first line support/single point of contact with contracted specialty pharmacies to identify and escalate issues and cases
Responsible for analyzing incoming data and recognizing trends and cases that need further action. Ensure all contractual timeframes related to SP data review are successfully met, if applicable
Lead weekly (more or less frequently as needed) calls with each contracted SP to review patient statuses to include those at risk of lapsing in therapy, shipment and/or insurance delays, missing shipment and updates as applicable. Provide timely tracking of receipt of referral, status of contracted SP activity, and potential interruptions in therapy
Gathers, analyzes, and prepares data, including Adverse Event trending, for Quarterly Business Reviews (QBRs), FDA requirements, and other special projects and reports as applicable
Bachelor’s Degree and 0-2 years of experience or 6-8 years relevant working experience
2 years experience in a customer service setting, preferably in a call center environment
Previous experience in the PBM and/or healthcare industry preferred
Demonstrated team lead experience preferred
Advanced problem solving and trouble-shooting skills
Strong team building skills and the ability to train other team members
Research, analysis, report preparation and documentation skills

Manager, Local Specialty Pharmacy Resume Examples & Samples

Ensures that store personnel provide hospitable service and information, and are courteous, friendly, and efficient
BS in Pharmacy or PharmD Degree from an accredited educational institution
Current pharmacist license in the state where the site is located or willing to obtain by position start date. Must maintain active license
At least 2 years of experience in indirect management of team members, including assisting in the development, training and assignment of work/projects to other team members, or completion of a residency
At least 2 years of experience planning, developing, and managing departmental expense and capital budgets
At least 2 years of experience directly managing people, including hiring, developing, motivating and directing people as they work

Specialty Pharmacy Coordinator Resume Examples & Samples

Work with healthcare providers and patients to assist with appeal management for claim
2+ years medical or insurance industry experience
5 years experience in the healthcare industry including, but not limited to, Medicare and/or Medicaid program administration, insurance verification and/or claim adjudication, physician’s office or outpatient billing, pharmacy and/or pharmaceutical manufacturers
Must be able to analyze reimbursement specific data and prepare written reports for management and client communications
Strong problem solving and decision making skills
Ability to effectively handle multiple priorities within a changing environment
Proficient with MS Office (Strong Excel skills preferred)
Proficient with MS Outlook
ICD-10, HCPCS, CPT experience

Specialty Pharmacy Program Senior Manager Resume Examples & Samples

Serve as the primary point of contact for the Brand team for programs across all SPs on implementation of contracted programs, including operations and performance management
Lead the planning, tracking and implementation of Specialty Pharmacy programs by serving as the business unit liaison with cross functional teams
Establish/apply quality objectives, criteria, standards and levels using appropriate quality management methods, with stakeholder input (e.g., key performance indicators, scope definition
Specialty Pharmacy, Pharmacy Benefit Management (PBM), or health plan experience
Previous Field, Access and Reimbursement experience from a program development, marketing, sales, or operational standpoint
Project management experience preferred – ability to track complex projects and bring tasks to completion on time and within budget
Process management experience – the ability to document processes and improve them to eliminate waste

Specialty Pharmacy Account Executive Resume Examples & Samples

Responsible for managing the pharmacy relationships across key national and regional accounts, often in collaboration with our payer team
Serve as the primary point of contact for specialty pharmacy activities including contracting, and implementing fee for service programs including operations and performance management
Support the implementation of complex projects spanning across business units where research/analysis requires evaluation of business requirements, development of achievable short/long term objectives, and coordination of interdependent activities to ensure the successful implementation of program initiatives
Support program development, value proposition, oversight, and day-to-day management for specialty pharmacy programs include: Pharmacy based patient clinical management programs, Provider programs, Pharma services (Adherence Program, Patient Assistance, Hub Triage, Value Based Contracting, Pharmacy and Medical Benefit Clinical Programs
Travel to Specialty Pharmacies to ensure successful implementations
Report program performance against expectation and influence changes to programs to improve competitive position and optimize performance
Lead or help develop program or project scope statements, in consultation with applicable stakeholders (e.g., Brand Teams, RAV, OCT, GSS, and Legal)
Call center / reimbursement hub management experience preferred, call center / reimbursement partner management experience a plus
Previous Access and Reimbursement experience from a program development, marketing, sales, or operational standpoint
Prior managed health plan, pharmacy benefit and specialty drug management experience preferred
Understanding of managed care and pharmacy benefit cost management levers preferred
Communication skills – strong spoken and written communication skills to translate Amgen business requirements into operational programs at a partner operation, and ability to effectively navigate to win-win agreements across diverse internal and external partner groups

Director of Specialty Pharmacy Resume Examples & Samples

10+ years of related work experience in biotech/pharmaceutical industry, preferably with some managed markets account management experience
Proven track record of developing and maintaining strong relationships with National Health Plans, Managed Care Organizations, Pharmacy Benefit Management companies, channel/specialty pharmacy experience
Significant finance and strategic experience across operations, accounting/finance, sales with deep knowledge of pharmaceutical industry and trends
Demonstrated excellent financial and analytical skills
Experience successfully leading teams, including direct reports to exceed corporate objectives
Excellent interpersonal, leadership, and coaching skills to direct reports or in a matrix organization
Ability to develop and present comprehensive, enterprise-level strategic plans to exceed corporate objectives of the Sandoz Leadership Team
Ability to execute tactics with direct reports or matrix team that supports the corporate objectives of the organization
Ability to analyze highly complex, quantitative and qualitative situations and make effective recommendations
Strong time management skills with the ability to prioritize activities based on overall value
Ability to integrate Company and customer interests in the development of effective proposals
High level of business planning and organizations skills
In-depth understanding of Managed Markets marketplace as well as benefit design or reimbursement issues and experience with biologics and biosimilars preferred
Demonstrated business acumen applied to achieving portfolio priorities
Proven track record of developing and maintaining strong relationships with National health plans, GPOs institutional/LTC/Oncology, Specialty Distributors, and Government agencies
Field based, thus travel by vehicle (and where necessary airplane) in the assigned territory as directed, promptly and efficiently, meeting at least 50% travel requirements

Specialty Pharmacy Representative Resume Examples & Samples

Bachelor’s degree in business, healthcare or related field is required
1 year of sales, account management or hospitality experience is required
Basic understanding of MS Office (Word, Excel, PPT) is required
3 years of experience in healthcare, pharmacy or reimbursement is preferred
Strong communication and follow-up skills is highly preferred
Sense of autonomy and independence is highly preferred

Associate Director of Patient Services Specialty Pharmacy Resume Examples & Samples

Executing marketing analyses capturing relevant distribution market dynamics
Business case development and distribution-focused strategic planning for Biopharma products and portfolio
Collaborate with internal teams to negotiate and implement new distribution strategies
Regular interactions with brand teams and other key stakeholders to share analyses and insights
Participate in yearly strategic planning and budget exercises

Cigna Specialty Pharmacy Accreditation Lead Resume Examples & Samples

Assist in the management of accreditation requirements and work with all appropriate business partners
Possess a thorough understanding of CSP’s interpretation of URAC Specialty Pharmacy standards (and other accreditations) in order to be the source of information for Specialty Pharmacy URAC (and other accreditations) compliance questions from within the pharmacy
Facilitate and drive the meetings to reassess and evaluate CSP patient management programs as well as work on performance improvement projects for increased service with the patient management programs as part of accreditations
Enable CSP to be adequately prepared for any changes to URAC requirements during monitoring visits and reaccreditation surveys by reviewing accreditation standards to ensure the pharmacy continues to remain compliant at all times
Participates in and/or facilitates the design, development, and implementation of new operational controls, performance metrics, and automated processes as associated to accreditations
Develop, document and maintain analytical reporting in regards to accreditations that are crucial to the Specialty Pharmacy growth
Attend communication meetings with other accredited areas of the business to ensure CPS’s interpretation of core standards is consistent with accredited matrix partners and for increased knowledge as CSP SME on accreditation measures
Create communications to share at supervisor team meetings and joint team meetings. These should include accreditation compliance reminders, definitions and other information to keep the accreditation fresh in between reaccreditation initiatives
Maintain documentation on accreditation reporting standards and ensure all reporting requirements are met as needed
Work with Cigna HR department, CSP training and CSP supervisors to ensure employee personnel files meet all accreditation requirements
Work with Cigna matrix partners (TheraCare, Medical Billing, Procurement, and Production) across the business to ensure contributions to CSP accreditations remain accurate and consistent
Assist Supervisors with internal audits on CSP staff and operations as they relate to accreditation requirements to ensure full compliance and minimize risk during monitoring visits and reaccreditation surveys
Coordinate CSP policy and procedure (P&P) review and updates in conjunction with policy owners and national P&P committee
Update CSP URAC Cigna University training with new standards and information as needed
Provide required URAC new hire and annual training and work with Cigna U to continually update training materials
Monitor certification, licensing and registrations to ensure no lapses occur that could result in risk for obtaining or renewing accreditations that are key to CSP growth
Be responsible for working with matrix partners to obtain the appropriate evidence as proof of compliance with Specialty Pharmacy and CORE Standards and provide that evidence for URAC Desktop Review
Coordinate closely with the CPM Quality Assurance area in providing documentation as required for CPM/UM and Specialty Core URAC standards
Key contact for URAC Auditors during On-Site Reviews providing information as requested including policies and procedures, job descriptions, training documentation, and coordinating interviews with key matrix partners
Assure that delegated entities are in compliance with URAC standards
Coordinate efforts to mitigate any risks as identified in Corrective Action Plans
3+ years of business experience in auditing and reporting required; compliance and URAC auditing background highly preferred
Specialty Pharmacy business knowledge required
Proficiency of Microsoft Word, Excel, and Power Point required
Experience in facilitating training content for knowledge transfer; excellent presentation skills required
Demonstrated ability to drive results required
Strong analytical and problem-solving skills required
Extremely detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards) required
Ability to establish and maintain effective professional working relationships with senior leaders, managers and employees, along with working with external clients/vendors
Act with a sense of urgency to research questions or issues brought by the team
Proven ability to act independently and decisively, with minimal supervision
Experience with continuous quality improvement methods and tools, such as Six Sigma, preferred
Ability to create and implement contingency plans and solutions for problems that arise preferred

Specialty Pharmacy Program Manager Resume Examples & Samples

Liaison with the SP Customer Facing Team to gather insights from SPs, deploy programs, and monitor contract performance and quality
Support access team with creation of specialty pharmacy tools required for pharmacy use or for internal training, or HCP/patient use
Lead or help develop program or project scope statements including SOW/ contract langauge, in consultation with applicable stakeholders (e.g., Brand Teams, RAV, OCT, GSS, and Legal)
Experience relevant to Products: Enbrel and Repatha, or in respective therapeutic class
Analytic experience – Microsoft Excel skills (ability to create and troubleshoot calculations), attention to detail
Ability to work through others and mange in a matrix environment

Specialty Pharmacy Analytics Project Manager Resume Examples & Samples

Apply project management methodology during all phases of the project cycle, with responsibilities including project design, scope management, and both quality and performance reporting
Organize and lead matrixed teams in the delivery of high-quality programs and solutions that meet business needs
Create detailed project design documents and task-level project plans to organize cross-functional teams
Partner closely with other members of functional project teams to define business requirements
Effectively manage scope, issues and timelines toward meeting defined dates and deliverables
Prepare and present project plans, status and updates to management
Prepare and present cost-benefit analyses
2-4 years of demonstrated success leading projects, including technology solutions
Demonstrated success leading initiatives that deliver well defined solutions
Strong influencing skills and demonstrated experience leading matrixed teams
Project Management Institute PMP certification

Specialty Pharmacy Liaison Resume Examples & Samples

Identification and qualification of patients eligible for medication patient assistance programs and foundations. Interfaces with program administrators for reimbursement assistance programs sponsored by the drug manufacturer. Tracks, documents, and reports out cost savings associated with patient assistance drug recovery programs and provides updates to pharmacy management. Provides manufacturer coupons to patients, if available
Assists the pharmacist in all operational activities of the pharmacy in order to optimize customer satisfaction and maximize profitability of the pharmacy. The specific duties would include customer relations, computer and prescription filling, drug orders and inventory, marketing, accounting and any supportive tasks involved with workflow. Responsible for policies and Proceedures (as they pertain to operations, quality assurance, goals and priorities)
Customer Service- communicate with patients in a friendly, welcoming manner with greeting provided by management. Completion of updating accurate demographic information such as address, birthdate, insurance information and allergies. Provide appropriate waiting time via telephone or in person. Responsible for finding a patients insurance information if the patient is unable to provide. The "Service for Excellence" mission provided by YNHH is the main focus. Awareness of all of the "non-negotiables" (10/5 rule, no venting, library voices, AIDET and the Pledge to Service of Excellence)
Computer and prescription filling- demonstrates proficiency in cross-funtional areas of the department, including (but not limited to) QS/1, Mckesson ordering process, Epic, Therigy, Emdeon, Macro Helix, Employee Self Service and the DSS website. Responsibilities also include awareness of specific programs (MAP, Workers Comp, Columbus House, etc) and how to process prescriptions within these programs. Responsibility for regulatory awareness and reporting of medication errors
Drug Orders and Inventory - accumulate information on prescription drugs needed. Place and transmit orders daily into Mckesson. Review reports from Macro Helix and the management of our 340B inventory. Report any discrepencies to management and review weekly for prescriptions not picked up and return to stock every 14 days. Review backordered items to see if another source can be ordered. Review and verify 340B reports
3-5 years of retail pharmacy technician experience, specialty pharmacy technician experience preferred. Experience with direct patient counseling and excellent customer service skills are required

Specialty Pharmacy Patient Care Coordinator Resume Examples & Samples

Responsible for providing phone and on-line support for patients, prescribers, insurance companies and retail pharmacies, ensuring a specialty pharmacy patient gets and takes their medicine
Responsible for entering the patient information including name, date of birth, insurance information, allergies and medication history into our therapy-specific patient assessment software (TherigySTM)
Responsible for maintaining telephone communication with patients, local Publix pharmacies, prescribers, and others in the Central Pharmacy and RBU to ensure quick delivery of the patient’s specialty prescriptions
Responsible for monthly follow-up calls to patients to assess compliance with drug therapy, identify any barriers to patient adherence (for example, the patient cannot pick up the medication because it is too expensive or the patient feels like he/she has too many medications to take, or the patient can’t remember to take medications) and facilitate discussions with the Clinical staff to help the patient overcome barriers and process refills. Patient Care Coordinator will process prescriptions within the EnterpriseRx system
Responsible for supporting the Intake Department Lead
1 year experience working in a retail, mail order or specialty pharmacy
Registered with (or able to be registered with) the State of Florida as a “technician in training”. Must become a state registered technician within 6 months of hire
Broad knowledge of retail pharmacy and the healthcare environment and industry
Knowledge of multiple pharmacy software systems such as EnterpriseRx, and other software used in pharmacy and healthcare, (such as medical billing software, coding and procedures), Microsoft Office. Medicare billing knowledge is highly valued
Knowledge of Specialty Pharmacy Accreditation Standards (i.e. URAC)
Knowledge of pharmacy and healthcare laws, rules and operating policies and procedures (ex. HIPAA)
Various computer skills
Data management and correction skills
Ability to communicate effectively and professionally in both written and verbal format
Excellent planning, organizational and time management skills; autonomy and self-motivation
Flexibility and adaptability skills
Analytical skills for independent problem solving
Willingness to work a flexible schedule with extended hours
Bachelor’s degree (BS or BA) in a healthcare or business related field
2+ years’ experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment
Certifications within the specialty pharmacy industry

Specialty Pharmacy Reporting Resume Examples & Samples

Drives specialty technology solutions that meet business needs with consideration for time, schedule, and cost
Acts as a business project manager to execute / lead projects from project inception through to deployment
Takes part in contract reviews, negotiations, and contract edits as related to data obligations. Acts as the subject matter expert in data related matters, including business requirements
Develops pharma reporting specifications and requirements
Focuses efforts on specialty pharmacy program reporting and data projects required in support of contractual commitments
Partners with IT and internal Pharma Reporting development team to identify and execute deliverables based on project scope driven by contractual commitments
Represents business interests in technology projects, providing business insight and a single point of contact for business throughout the project lifecycle
Creating / updating operational decision and infrastructure support tools including executive dashboards, reports, and templates
Supports / coaches other colleagues that are part of the project team to learn and apply skills directly tied to the project lifecycle. Acts as an application subject matter expert, provides guidance to more junior staff on system capabilities and enhancements
Will partner with internal personnel to resolve production related issues for end users / clients
Use a consultative approach to ensure our internal and external client’s needs are being met; may support colleagues in training or working sessions to support internal / external clients

Cigna Specialty Pharmacy Home Delivery Support Associate Resume Examples & Samples

High School Diploma or equivalent required. Some college courses preferred
Problem solving skills, attention to detail, and strong communication skills required
Ability to achieve current department standards in both quality and productivity is required
Strong data entry, typing skills and proficiency in the use of a PC, including use of multiple applications simultaneously required
Ability to locate and interpret complex information from approximately multiple computer applications residing in a Windows environment
Capacity to work in a production and quality environment to meet required standards
Ability to succeed within a team environment
Demonstrated high-level communication skills through expressing thoughts and information clearly and succinctly

Specialty Pharmacy Program Specialist Resume Examples & Samples

Bachelor’s degree in Healthcare, Finance, English or related area of study required
3 years of experience in pharmacy setting required (5 years preferred)
Experience with prior authorizations, copay assistance, conducting benefits investigations in a specialty pharmacy/pharmacy environment strongly preferred
Experience with pharmacy accreditation process is strongly preferred
Pharmacy Technician Certification is a plus
Must be highly organized
Must possess strongly written and verbal communication skills
Must be a team-player

Specialty Pharmacy Insight Manager Resume Examples & Samples

Bachelors required; MBA or Master's degree preferred in Business Administration, Marketing, Economics, Statistics, or other relevant discipline
7+ years’ experience with healthcare and pharmaceutical data strategy
3+ years in the specialty market: preferably experience in managing, cleaning and/or analyzing specialty care data directly from Specialty Pharmacies
Expertise in the reimbursement of specialty pharmaceuticals to guide decisions related to medical and pharmacy coverage
Experience using SAS, SPSS or other advanced analytic software
Experience with launching a brand in healthcare a plus
Strong interpersonal skills, demonstrated ability to work collaboratively with peers and strong consulting skills
Ability to build credibility and relationships with internal customers

Director Specialty Pharmacy Resume Examples & Samples

Doctor of Pharmacy degree from an ACPE accredited School of Pharmacy
5 years experience in a clinical pharmacy management role with demonstrated results
Proficiency in computer office applications (Word, Excel, Powerpoint)
Familiar with current clinical and therapeutic literature
Demonstrates the capability to perform in specialized areas and services
Familiar with regulatory standards and guidelines (ie. NPSG, Accrediting Organization, Core Measures)
Good interpersonal skills, to deal with a wide variety of individuals
Good communication skills to achieve understanding and acceptance
Ability to gather data and prepare cost analysis reports
Illinois state licensure as a Registered Pharmacist
Ability to manage multiple tasks simultaneously and prioritize work to complete urgent tasks preferentially
Schedule flexibility to meet the needs of the system, adaptable to changes in workload and/or work schedule
Ability to travel to various hospitals
Directs the development of Advocate Specialty Pharmacy
Directs clinical outcomes of specialty pharmacy services
Oversees financial aspects of reporting departments
Human Resources

Specialty Pharmacy Service Coordinator Resume Examples & Samples

High school diploma or general education degree (GED)
One year of pharmacy experience (i.e. technician), or one year of working in complex medical office/practice
One year experience must include working with medical protocols, patient billing, various payors, registration and the referral process, chart review, and knowledge of ICD and CPT coding
Thorough understanding of prior authorization as necessary for specialty medications and ability to navigate that process, including external resources
Ability to communicate and relay information in meaningful way to achieve successful outcomes for patients
Strong analytical and documentation skills
Strong orientation toward customer service
Previous experience working with patient assistance programs, working within Epic Hyperspace or Willow Ambulatory (preferred)
National pharmacy technician certification (CPhT) preferred

Specialty Pharmacy Account Liaison Resume Examples & Samples

Manages major account relationships as the primary point-of-contact for day-to-day issues, including ongoing communications, and coordination of project, billing and other activities
Demonstrated ability of managing projects driven by new business opportunities
Ability to provide resources responsible for managing the relationship and ensuring delivery of contractual obligations
Preparation of standard client monthly reporting packets and ad hoc reporting as requested by the client
Create and execute project work plans and revise as appropriate to meet changing needs and requirements
Facilitate regular client meetings effectively
Conduct regular business review session with key clients
Resolves and/or escalates issues in a timely fashion
Serve as a liaison with IT Services to facilitate projection completion for assigned clients
Identifies opportunities for improvement and makes constructive suggestions for change
Builds a knowledge base of each client's business, organization and objectives
Suggests areas for improvement in internal processes along with possible solutions

Senior Program Manager Specialty Pharmacy Programs Resume Examples & Samples

Evaluates vendor performance and ensures compliance with contractual standards and applicable federal regulations. Evaluates operational processes and assesses the impact on program and member services relative to FEP performance goals. Investigates non-performance and directs vendor efforts to ensure corrective actions are implemented timely. Assumes leadership role among staff to ensure appropriate delivery of member benefits consistent with FEP policies. Reviews and understands FEP Operations Center (FEPOC) claim processing protocols for prescription drug- claims. Serves as a liaison between FEPOC and PBM in resolving claims processing issues
Leads Strategic Initiatives and executes multiple cross-functional projects to maintain and enhance customer satisfaction with FEP Pharmacy Programs. Ensures timely resolution of customer inquires (members, Plans, OPM, Congressionals, Internal FEP Staff). Reviews PBM standard operating procedures (SOP) for Call Center management and training materials and curriculum for customer service representatives to ensure optimal service is provided to FEP members. Reviews Front-end and Back-end pharmacy SOP to ensure optimal service for FEP membership. Monitors Specialty Pharmacy fulfillment and member services
Leads the design, development and distribution of multiple communication materials necessary for educating members, Plans and OPM on the structure of the pharmacy benefit. Responsible for ensuring vendor maintains and updates its website and coordinates all updates in sync with the fepblue.org website. Serves as the subject matter expert for the review and update of the Specialty Pharmacy Program policies detailed in the Administrative and Benefit Policy Manual and the Service Benefit Plan brochure
Ensures timely receipt and review of all contractual reports – operational, financial, and clinical. Develops report summaries that highlight critical performance metrics for Senior Management review
Guides the day-to-day account relationship with the Rare Disease Management Vendor. Evaluates vendor performance and ensures compliance with contractual standards and applicable federal regulations. Evaluates operational processes and assesses the impact on program and member services relative to FEP performance goals. Investigates non-performance and directs vendor efforts to ensure corrective actions are implemented timely
Oversees all efforts related to RDM Accreditation. Collaborates with FEP’s Sr. Program Manager of Accreditation and RDM vendor’s Accreditation expert to ensure all Accreditation related policies and reports are up to date and are available to Plan consumption
Bachelor’s Degree in Pharmacy, Business, Accounting, Management or Health Services, or the equivalent years of experience
Minimum 7 years business experience within a business environment
Minimum of 5 years’ experience within a national health care and managed pharmacy delivery system
Pharmacy or Master’s Degree in health services degree or equivalent experience
Pharmacy related operations experience
Progressive experience in large account management and/or project management
Ability to manage stakeholders and reconcile and integrate competing interests
Prior project/program leadership experience that demonstrates the ability to set priorities and meet objectives for several complex projects involving multiple stakeholders

Infusion Nurse for Specialty Pharmacy Resume Examples & Samples

Ensures that professional and skilled nursing care has been provided to assigned patients as outlined in the physician’s Plan of Care
Performs a complete assessment of assigned patient’s ongoing physical and emotional status, level of competency, home environment, safety factors and family support available to assist with care and needs of patient
Reports to supervisor on services rendered, problems concerning patient’s needs and resolution to those needs; reports to the physician any changes of the patient’s condition and reaction to treatment
May participate in the patient care planning conference and revision of Plan of Care as changes occur
Provides information on patient rights, reimbursement procedures, and patient/family rights
Initiates and applies appropriate preventative, therapeutic and rehabilitative nursing procedures and techniques as ordered by the physician
Administers medications and intravenous solutions
Completes all documentation in a timely manner; maintains patient clinical records and reports in accordance with company policies and as required
Trains patients and/or caregivers in all procedures and equipment; counsels patient and family members regarding patient care needs
Participates in on-call rotation as necessary; participates in in-services as required
Inventories patient supplies and informs pharmacy of patient needs
Coordinates patient’s care with other home care agencies as necessary
Provides goal directed care leading to specific outcomes
May instruct and supervise other nursing personnel as required
May be on call for after-hours work; travels by automobile and requires valid driver’s license and motor vehicle insurance
Bachelor’s degree required. BSN is preferred
BCLS certification is required
At least 1 year experience recent hospital or home care experience. Infusion experience preferred
Unrestricted current license as a Registered Nurse in resident state is required
Demonstrated knowledge of nursing processes and principles
Demonstrated proficiency in IV insertion, vascular access devices and infusion pumps
Excellent communication skills, both oral and written

General Manager Specialty Pharmacy Facility Resume Examples & Samples

Oversees the management of the Specialty Pharmacy supporting special needs of patients with diseases such as Oncology, Fertility, MS, RH, Hepatitis C, IV, and other disease states managed through prescription and infusion drug therapy
Ensures that the facility maintains and improves profitability, through regular reporting, monitoring and management of the Profit and Loss (P&L) reports and statements
Develops and monitors key performance indicators to measure, report and improve on time delivery performance to patients, group homes and hospitals and customer satisfaction. Directs and ensures the performance and execution of all areas of the facility, including facility performance, operations plans, organizational structure, schedules, accurate on-time deliveries, and management of the facility human resources
Assures that the inventory maintained at the facility is secured, monitored and controlled
Negotiates the terms of contracts with group homes and other entities for long term provision of specialty drug therapy for client groups
Ensures Pharma programs including facility adherence to Federal trade Commission, Drug Enforcement Agency, federal, state and local laws and regulations; and Corporate and WHS policies and procedures regulating drugs, loss prevention, health and safety
Prepares the annual facility budget, including forecasted sales volume and expenditures. Recommends, and directs the facility’s annual payroll and expense budget. Monitors and controls the use of overtime and ensures safety and security of the facility including its inventory and personnel
Represents the Company and the facility at community, business, social and public functions (including business and trade associations) in a manner to best serve the company’s interests and to achieve and maintain good public relations for the Company
Recommends, implements, and controls policies and procedures designed to identify and minimize profit loss
Oversees the implementation and training of facility personnel in the WHS and Walgreen Co pharmacy systems, including Intercom Plus and other requisite facility systems
Bachelor’s Degree and at least 5 years of experience in General Manager or senior Manager in a Central Fill Health Care Setting to include Specialty Pharmacy, Mail Service, Home Care, or LTC
Knowledge of Profit and Loss statements
Experience coordinating and facilitating executive management meetings
Experience negotiating with outside vendors, including negotiating contracts, prices, resolving service issues and reconciling differences
Experience directly managing people, including hiring, developing, motivating, and directing people as they work
MBA RPH

VP-specialty Pharmacy Strategy & Business Development Resume Examples & Samples

Develops Lash Group’s strategic growth plan in specialty products and executes through direct sales activities with specialty manufacturers
Provides functional expertise, industry knowledge and specific recommendations to Lash Group leadership on specialty products and SPP-related programs, policies, services and finances
Gathers and analyzes information on market and industry dynamics that may affect the business relationship between Lash Group and SPPs. These dynamics may include manufacturers' changing requirements, changes in SPP service models and/or new affiliations with payers, manufacturers and other financial stakeholders, competitor strengths and weaknesses relative to SPP strategy and opportunities for new growth
Develops business strategies to account for market and industry dynamics and may guide or lead implementation
Communicates business strategy related to SPP’s internally through a comprehensive action plan and routine tactical updates to leadership
Develops and maintains strong relationships with SPP contacts; seeks new and increased business opportunities through those relationships
Visits designated manufacturer and SPP accounts in a manner and frequency that is consistent with the strategies defined in the strategic plan
Regularly, monitors and analyzes specialty product industry news, conferences and trends seeking growth opportunities for Lash Group
Evaluates customer issues related to specialty pharmacy, identifies root cause, and takes steps to prevent similar issues from arising in the future
Responsible for delivering presentations to key manufacturer and SPP contacts; negotiates partnership opportunities
Must be willing to work extended hours, as needed, in order to meet strategic objectives; must be willing to travel extensively
May have dotted line management responsibility for specialty pharmacy personnel across Lash Group operational programs
Routinely monitors current Lash Group programs in the specialty product space and assesses opportunities for improvement in service delivery, operational efficiency and customer experience
Assists the Sales Operations team in development of RFP responses specific to specialty products
Performs related duties as assigned, at the direction of the SVP, Business Development
Deep knowledge of, and practical experience in specialty products, specialty pharmacy operations, service delivery, contracting, finances and performance measurement
Ability to learn and understand Lash Group’s service offering and operations
Ability to communicate effectively, both orally and in writing, for the purpose of preparing plans, reports and disseminating information
Strong interpersonal skills; ability to develop and maintain cooperative business relationships, internally and externally
Strong analytic skills
Ability to interpret data specific to specialty products, SPPs and/or Lash Group service levels and identify issues requiring action
Ability to interpret industry trends and competitive information and develop strategies and tactics to respond to changes in the marketplace
Strong creative thinking skills and ability to convert abstract ideas into actionable plans
Ability to identify and coordinate sales opportunities for Lash Group’s business development team
Working knowledge of computers necessary to operate effectively with company systems and programs
Ability to accommodate at least 50% travel

VP Specialty Pharmacy Resume Examples & Samples

Provide direction for specialty assets with a focus on optimizing the current model, growing it to a broader, robust, and integrated offering for the Specialty enterprise
Responsible for providing guidance and strategy to market leaders in order to develop, grow, implement, and increase overall margin generation activities for the delivery of pharmacy operations
Drives process enhancements and new initiatives into the locations, ensuring that the changes are well received by both clients and patients
Lead the development and execution of operations strategy to meet the long term market and business objectives for the organization
Represent the Senior Leadership Team; accountable for the effective management of operations, development and monitoring of key performance indicators, and appropriate budget and resource allocation in order to serve our customers
Manage all key specialty operational systems – benefits verification, referral and order entry, pharmacy and medical coverage eligibility, prior authorizations, dispensing and shipping, purchasing and inventory control, and specialty therapy management
Direct the development and implementation of operations information systems, intellectual property regarding operating systems and processes, clinical services and patient care support to achieve optimal patient outcomes and drive physician loyalty and pharmacy decision support; refine operational reporting, tracking, and response systems to ensure a zero defect operation
Work with healthcare partners, other insurers, pharmacy benefit managers, employer groups, unions, government and other third party programs to coordinate Specialty Pharmacy and associated Disease Management Services, relevant provider fee schedules, dual coverage issues, and client reporting activities
Bachelor’s Degree and at least 15 years of experience leading operations or similar areas for a Pharmacy Benefit Management (PBM), specialty pharmacy, health plan managed care organization, or relevant industry, with a minimum of 10 years in pharmacy benefit management, 5 years in specialty pharmacy
At least 5 years of experience planning, developing, and managing departmental expense and capital budgets
At least 5 years experience directly managing people, including hiring, developing, motivating, and directing people
Willing to travel up to 25% of the time for business purposes (within and out of state)
Experience in a senior director/middle management level pharmacy position with comparable responsibility for scope of complexity, organization-wide reach, budgets, subordinate reports and meeting strategic goals
Experience in implementation of complex change initiatives (vendor management, process change, marketing and sales strategies, and six-sigma methodology)
Experience in representing the company in industry and trade groups, key physician providers, government representatives and regulatory agencies, brokers, and the general public
Experience with strategy development and management in a matrix environment
Experience leading cross-functional teams to meet business objectives with outstanding results

Specialty Pharmacy Liaison Resume Examples & Samples

Provide consistent and effective communication to all appropriate stakeholders as first line support/single point of contact with contracted specialty pharmacies
Identify, investigate and resolve escalated issues and cases related to complex reimbursement from both internal and external stakeholders
Responsible for analyzing incoming data and recognizing trends and cases that need further action. Review all incoming daily data from the contracted SP, review exception errors generated from each contracted data feed, and outreach to contracted SPs related to outstanding restatements. Ensure all contractual timeframes related to SP data review are successfully met, if applicable
Lead weekly (more or less frequently as needed) calls with each contracted SP to review patient statuses to include those at risk of lapsing in therapy, shipment and/or insurance delays, missing shipment and updates. Provide timely tracking of receipt of referral, status of contracted SP activity, and potential interruptions in therapy
Provide training and education to contracted SPs about the program, processes, and data requirements
Attends manufacturer national sales conferences as applicable
Attends manufacturer/SP QBRs and other manufacturer meetings as requested
Bachelor’s Degree and 3-5 years of experience or 8-11 years relevant working experience
Previous experience in the PBM and/or healthcare industry required
5 years experience in a customer service setting, preferably in a call center environment
Proficient in Microsoft Office applications
Ability to handle a fast paced environment
Demonstrated customer service resolution skills

Specialty Pharmacy Regional Account Manager Resume Examples & Samples

Developing/positioning Publix as a Specialty Pharmacy leader and drive Specialty Pharmacy business,
Working with the Specialty Clinical and Operations internal team and the Retail locations in the territory to ensure seamless pull through, as it relates to key selling messages,
Conducting sales data analyses and monitoring competitor behavior to develop appropriate sales strategies and business plans to generate recognizable increases in business in the assigned territory,
Entering all sales call activity into the Customer Relationship Management (CRM) application. The information should be entered for the express purpose of maximizing sales and improving upon the business relationship,
Demonstrating expertise and a commitment to maintaining in-depth knowledge of highly complex market dynamics (including payer issues, state and government regulations, provider payment issues, drug launches, etc.) within complex disease states (Oncology, Rheumatology, Cardiology, Infectious Disease, etc.),
Partnering with Pharmaceutical Sales Representatives around common objectives to coordinate selling efforts
Bachelor’s (BA or BS) degree or equivalent experience
2-3 years of demonstrated, successful outside sales experience in pharmaceuticals or other health related field, OR 2-3 years of demonstrated, successful experience as a Publix monthly, salaried associate,
Knowledge of Specialty Pharmacy industry trends, best practices and targeted disease states and corresponding treatment regimens,
Knowledge of Specialty Pharmacy processes and procedures
Knowledge of Prescribers
Knowledge of CRM applications (such as salesforce.com)
Negotiation and Persuasion skills
Excellent verbal communication and presentation skills
Analytical and reporting skills
Advanced degree (i.e., MBA, PharmD)
3+ years’ experience as a demonstrated, successful outside medical sales associate (preferably in an Oncology, Infectious Disease or Rheumatology, or Dermatology field)

Specialty Pharmacy Fulfillment Pharmacist Resume Examples & Samples

Maintains documentation relative to the job
Performs counseling as needed
Maintains and fosters and environment of teamwork and engagement
Participates in special projects/committees as needed

Specialty Pharmacy Liaison Resume Examples & Samples

Understands product and payer reimbursement landscape and prior authorization guidelines and processes
Collects and reviews all data needed for prior authorization approvals
Resolves insurance related issues, including prior authorizations (PAs), and assist patients with various forms of financial assistance
Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly; maintains frequent phone contact with patient, provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate
Serves as the direct patient and provider contact for pharmacy benefit information, clinical and program information
High School diploma or GED required
License Pharm Tech Cert Board preferred
3-5 years related work experience required in Healthcare
Working knowledge of the 340B program, state and federal laws
Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access
Associates or Bachelor's degree preferred
Pharmaceutical, biotech, or specialty pharmacy industry experience and history of building business relationships from the ground floor with health care strongly preferred
Knowledge of medication use in RA, GI, transplant, hepatitis C, infectious disease (including HIV), and/or oncology a plus

Specialty Pharmacy Sales Manager Resume Examples & Samples

Defining, developing, implementing, and continually monitoring strategic Sales Team’s objectives and goals to ensure maximum market share and profitability of the Specialty Pharmacy
Overseeing and directing the day-to-day activities of the Sales Team to ensure sales monthly, quarterly and yearly goals are being achieved and exceeded
Managing, training, coaching, and developing Sales Team associates
Managing the Customer Relationship Management (CRM) application (salesforce.com) for the Publix Sales Team
Bachelor’s (BA or BS) degree
2-3 years sales experience (preferably in pharmacy, PBM or managed care industry) selling to and maintaining physician office-based accounts
Specialty Pharmacy Industry trends and best practices
Knowledge of Sales principles, practices, and tactics
Knowledge of Prescribers, Manufacturers, and/or Third Party Payers
Ability to display professionalism
Effective negotiation and persuasion skills
Excellent managerial skills
Excellent planning, organizational, and time management skills
Verbal communication and presentation skills
Ability to work with no to little supervision
Basic level Microsoft Office skills
Willingness to travel
5+ years sales experience in Pharmacy, Healthcare, PBM or Managed Care industry and 2 years’ experience as a manager

Strategic Account Manager, Specialty Pharmacy Resume Examples & Samples

A minimum Bachelor’s degree is required
A minimum of four (4) years progressively responsible and related specialty pharmacy pharmaceutical experience; experience with sales, the pharmaceutical industry and marketing is preferred
Travel (up to 15-20%)
Highly-motivated, self-driven contributor
Specialty pharmacy experience
Ability to work both independently and in a team environment
Understands future trends in general health care
Experience, knowledge and ability to rapidly learn scientific, medical, financial and regulatory detail as necessary
Excellent presentation skills
Demonstrates superior organizational and project management capabilities
Basic understanding of accounting and financial functions
Excellent oral and written communication skills, including ability to present and sell ideas and solutions
Dynamic customer relations skills, experienced negotiator
Ideal candidate will have specialty pharmaceutical experience with numerous contacts
Ability to commit to variable travel schedule as required

Specialty Pharmacy Program Manager Resume Examples & Samples

Communicates with multiple branches to validate accuracy of data for manufacturer reporting
Develops and implements standard operating procedures to ensure efficient delivery of products and services including billing and collections
Forecasts, manages and measures operational performance to ensure meeting the requirements of the defined business plan performance goals and operating budget
Establishes and documents work procedures and standards to improve efficiency and effectiveness of the operation including coordination of various functional departments and training of staff
Primary contact for the client concerning operational issues
Addresses payer-related contract
Manages and directs staff of program coordinators billing A/R and administrative staff; responsible for forecasting and hiring additional staff as needed
Relies on expert experience and judgment to plan and accomplish goals; a wide degree of creativity and latitude is expected
Generates weekly detailed reporting and inventory reporting for manufacturer contracts
Responsible for quarterly reconciliation report for manufacturer contacts
Compiles and interprets reports relevant to program performance program demonstrated best practices and sales distribution
Interfaces with management companies such as the Lash Group and patient assistance foundations as well as the actual manufacturer partner for issues that relate to the day-to-day functionality of the Program
Strong leadership and staff development skills
Good mathematical skills
Ability to resolve issues effectively and efficiently
Knowledge of computers necessary to operate effectively with company systems and programs

Program Manager, Specialty Pharmacy Resume Examples & Samples

Manage specific aspects of internal program operations and development, including definition of the program vision, roadmap, and customer experience
Facilitate dialogue with broad group of cross-functional teams with a demonstrated ability to lead and influence decisions
Decisively drive and deliver new program development in a fast paced environment
Anticipate bottlenecks, provide escalation management, anticipate and make trade-offs, balance the business needs versus technical and operational constraints, and encourage creative and progressive solutions to maximize business benefit
Actively seek, survey, and document customer input for program improvement and drive implementation of enhancements
Contribute to the suggested feature set of the program platform by staying abreast of specialty market trends and changes, evolving models, stakeholder dynamics, and pharmacy trends
Develop and update the business case to support ongoing and future program investment
Partner with Marketing Operations to develop marketing plans to support the launch of program extensions. Help drive go-to-market planning to ensure successful program adoption and engagement
Partner with Marketing Communications to team build customer testimonials and marketing collateral
Serve as primary point of contact for all vendor and partner relationships
Oversee billing and support operations
Ensure program invoices and expenses are tracking to budget
Define program success metrics and report on program performance, sales, and customer utilization
Previous experience in Specialty Pharmacy, or Specialty Pharmaceuticals industry or in-depth knowledge of the Specialty Pharmaceutical market
5 years’ experience with product or program management experience
Demonstrated success at defining, launching, and managing new products
Previous vendor management experience
Ability to provide recommendations around strategic projects and drive approval process with stakeholders and C-level Executives
B2B Market facing skills
Experience in product/program development, innovation and/or health care (especially retail pharmacy) preferred +
Strong strategic skills building value proposition for sales force
Ability to facilitate dialogue and work cross functionally with multiple teams (finance, sales, marketing, execs and BD and strategy.)
Thorough understanding of pharmacy technology
Strengths in structured and logical thinking, problem solving, issue resolution, and attention to detail
Strong analytical and quantitative skills, including the ability to link program design and features to strategic objectives and use hard data and metrics to back up assumptions and recommendations
Ability to multitask, adapt to changing priorities, be decisive under ambiguity, and meet tight deadlines

Group Supervisor Specialty Pharmacy Resume Examples & Samples

Trains and coaches employees and keeps management informed of issues. Meets with employees on a regular basis to provide employee with performance feedback
Conducts timely performance evaluations for the subordinate staff; sets specific, measurable and realistic performance objectives; provides constructive feedback and recognition
Supervises departmental work activities, ensures accuracy of employee timecards, staffing, and scheduling to achieve business objectives
Maintains knowledge of disease states along with related medications and supplies to ensure accurate and complete information and services are provided to patients. Enforces communication guidelines for technician in accordance with pharmacy law
Provides support to all areas of the facility and assists with completion of operational duties including but not limited to prior authorizations, scheduled first orders, compliance calls, insurance verification, follow-up, enrolling patients and issue resolution
Monitors, audits and reports daily team and individual performance statistics and assists with extrapolation of data from system applications to develop reports regarding productivity trends. Advises management, analyst and trainer of findings and trends
Assists in the development, updating and implementation of Standard Operating Procedures related to system applications, programs, processes and merchandise
Participates in the recruitment process of potential employees and performance management of current employees including but not limited to screening applicants, interviewing, employment decision, performance evaluations and terminations
Acts as an agent of the company by projecting a positive attitude, enthusiasm, team spirit and integrity in order to motivate the team, creating a positive work environment, and reaching and exceeding department goals
High School Diploma and at least 1 year experience coaching or leading a work team
At least 1 year experience typing a minimum of 25 words per minute
At least 1 year experience communicating both verbally (on phone, one-on-one, to groups) and in writing (emails, letters, reports, presentations) to various audiences (work group, team, company management, prospective acquisitions, external clients)
At least 1 year experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions
At least 1 year experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems
At least 1 year experience in coaching, mentoring, and training staff
At least 1 year experience in managing teams across business units
At least 1 year experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines of multiple projects with varying completion dates
At least 1 year experience establishing and maintaining relationships with individuals at all levels of the organization, in the business community and with vendors
At least 1 year experience directly managing people, including hiring, developing, motivating, and directing people as they work
At least 1 year experience in indirect management of team members, including assisting in the development, training and assignment of work/projects to other team members
Willing to travel up to 5% of the time for business purposes (within state and out of state)
Associates or Bachelor’s Degree
At least 1 year experience in healthcare or pharmacy setting

Nurse, Specialty Pharmacy Resume Examples & Samples

Associates degree or Bachelor’s degree from an accredited nursing school as a Licensed Practical Nurse (LPN), Registered Nurse (RN), or Nurse Practitioner (NP)
Maintain certification as a nurse practitioner/registered nurse from a Board recognized national certification organization, which requires the passing of a national certifying examination in the particular specialty in which the applicant is seeking certification by the Board
At least two (2) years Insurance Verification and appeals experience required
Previous Medicaid/Medicare experience preferred
Prior Authorization review experience preferred
Strong organizational skills and a thorough knowledge of computers (Microsoft Office and Windows) are required
Demonstrated ability to work independently and meet goals Multitasking, Listening, Verbal Communication, Health Promotion and Maintenance
Ability to work in a fast paced environment while maintaining a positive attitude
Strong oral and written communication skills. Strong team player
Commitment to company values
Willingness to travel/visit physician office when requested by Sales Team

Pharmacy Tech-specialty Pharmacy Resume Examples & Samples

Setup of patient accounts in the pharmacy system and verification of insurance coverage
Ensure medication is available for rapid filling of prescriptions
Communicates and follow up with physician offices or clinics regarding prior authorizations
Works with insurance companies to obtain prior authorizations for patients
Ensures any copay assistance or charity care is provided to decrease the patients co-pay
Receives prescriptions and process them in a timely manner to ensure rapid delivery of medications
Communicate effectively over the phone to patients making refill reminder calls to improve medication compliance
Provides expertise and leadership in assigned area. Practices in a unique, specialized area of pharmacy practice as defined by pharmacy leadership
Uses resources available to find financial assistance to Specialty Pharmacy patients
Audits pharmacy records to determine where the pharmacy may provide more financial assistance
Acts a resource to other pharmacy staff members for daily operational issues including, but not limited to, EnterpriseRx troubleshooting, co-pay programs, billing options, shipping issues, and general problem solving
Experience in the area of insurance verification
Experience in obtaining prior authorizations
Experience with copay assistance programs
Experience in billing Medicare B and pharmacy claims as a medical benefit
Pharmacy Technician Certification Board (PTCB) national certification
Communication skills, both written and verbal
Ability to communicate clearly and concisely with all patients, caregivers, and clinicians

Manager, Specialty Pharmacy Solutions Resume Examples & Samples

Personnel management, including recruiting, training and developing your team
Has a strong understanding of the program support tasks needed to support daily operations
Ensures an optimal prescription fulfillment service focusing on scheduling on time delivery, reporting, invoicing, ordering, data integrity and communication
Manages accurate and timely processing of coordination services activities in compliance with internal and external expectations
Coordinates with Finance team to ensure accurate and timely pharmacy invoicing and receivables
Proactively provides Network Pharmacists with program enhancements to ensure an efficient patient-focused service
Creates strategies and tools for assessing and managing work allocation and work activities across the coordination services team
Ensures suitable staffing to meet business needs such as volume increases, absentees and new business
Coordinates fulfillments and produces special program and client mailings
Manages fulfillment supplies through purchase orders and inventory control
A minimum of 3 years of experience in healthcare / pharmaceutical related field
Proven customer relationship and/or account management skills with direct client interaction
Strong financial acumen and pharmacy coordination experience
General knowledge of reimbursement, patient assistance programs, database elements and functionality
A Bachelor’s degree program and/or an equivalent combination of experience and education is required
A degree in Pharmacy or Health Science could be an asset
Strong customer/client management background
Exceptional project management skills with experience in organizing, planning and executing projects from vision through implementation
Good Analytical, conceptual and problem solving skills with demonstrated track record in new concept development for various projects
The ability to manage multiple tasks along a parallel process
Ability to resolve associate issues effectively and efficiently
Ability to communicate effectively both orally and in writing and in both French and English (oral and written)
Posses strong interpersonal and leadership skills

Specialty Pharmacy Fulfillment Technician Resume Examples & Samples

Maintains inventory and ordering
Communicates and acts as liaison between insurance company, patients, providers, and specialty pharmacy team
Maintains efficiency in specialty pharmacy intake technician and specialty pharmacy refill advocate roles; Resonsible for Inventory, Ordering, Filling, and Packaging
Assists with special projects/ committees
Performs all job duties in accordance with Ochsner Specialty Pharmacy policies and accrediting bodies

Specialty Pharmacy Account Executive Resume Examples & Samples

Outstanding performance in developing and maintaining payer and internal customer relationships
SP channel experience, preferred
Demonstrated competence in financial modeling, budget impact models, and other payer and outcomes analysis
Demonstrated competence with business plan development, business management, contract development, negotiation and analysis
Outstanding performance as an Account Executive and demonstrated leadership skills in managing and influencing teams
Demonstrated excellence in account management, relationship development and account penetration
Demonstrated track record of being a significant contributor of high performing teams
Expertise in managed care markets, pharmaceutical distribution channels, competitive trends and the impact on UCB’s core brands
Reimbursement and MMA expertise
Demonstrated competence in leading account teams
Proven ability to launch and gain preferred product access with managed markets payers Oncology, CNS, RA, PsA, AS or Crohn’s Disease therapeutic areas
Extensive negotiation skills with large complex customers
Demonstrated superior account management and project management practices
Excellent understanding of biopharmaceutical marketing processes
Demonstrated strength in business planning and tactical plan development and execution
Excellent understanding of basic finance, return on investment and profitability analysis
Excellent understanding of clinical and marketing information on UCB and competitor’s products
Strong technology skills (e.g. computer skills – power point, excel, word, internet web sites)
Outstanding interpersonal skills and flexibility to meet customer demands

Coordinator, Specialty Pharmacy Resume Examples & Samples

Assist in identifying Specialty Pharmacy Formulary and Utilization Management opportunities, including participating in the Pharmacy and Therapeutics Committee reviews as assigned and reviewing the specialty pipeline at least twice a year. Identify, develop and implement evidence-based, policy opportunities specifically around off-label use, understanding LCDs and NCDs, clinical trials, etc
Assist in the development and management of a strategic plan for Specialty Pharmacy Management services
Assist in the development of clinical programs to wrap around our owned pharmacy specialty distribution programs
Assist in the development, implementation, and ongoing evaluation of the Health Plan's Specialty pharmacy offerings. Develop and manage pharmacy initiatives that efficiently focus on quality, appropriate and cost-effective utilization and client, member and provider satisfaction
Coordinate with internal operations teams to monitor the appropriate configuration of specialty medications
Critically review of medication based prior authorization requests for approval/denial against standard criteria
Interface with external partners, providers, clients, or customers, to ensure optimal Specialty prescription benefit design, implementation, and processes, including our specialty pharmacies
Mentor students and residents as a preceptor
Participate in committees relevant to strategic issues impacting specialty pharmacy
Regularly review and analyze department reporting to ensure compliance with the business plan and Health Plan processes and strategy
Responsible for ensuring timely and accurate regulatory reporting and compliance with regulatory and accreditation requirements if applicable
Through data analysis and drug utilization evaluations, identify and implement evidence based, best practice utilization opportunities within both the medical and pharmacy drug utilization translating these targets into effective UM strategies
3 years experience in a progressively more responsible managed care pharmacy setting
Experience in specialty pharmacy benefit management, insurance, managed care preferred and be knowledgeable in therapeutic interventions and other cost containment programs
Computer literacy for pharmacy programming, word processing, data management
Assessment of job related skills and competency will be reviewed annually via daily functioning, job-related documentation, department based competency programs, and continuing education activities

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