Specialty Pharmacy Patient Advocate

Location: Scottsdale, Arizona • BFP-Scottsdale Health Center • 18250 N Hayden Rd, Suite 103 • Day shift

About the role

This position will determine, support and assist patients, provider teams, and the pharmacy department to overcome barriers to medication access, with focused expertise in third-party prior authorization and billing processes for pharmacy benefits. Assist patients with enrollment into grants, assistance programs, and communicate any financial responsibilities. Provide a face-to-face bedside-oriented service that delivers comprehensive fiscal options to patients and provide medication cost after transplant. Gather and effectively communicate medical and medication histories including diagnosis, test results, lab values, and appropriate step therapy to third-party for initial insurance approval. Verify eligibility, benefit provisions, and support the appeals process.

Responsibilities

• Completing prior authorizations and communicating outcomes with providers and patients.
• Helping obtain financial assistance for patients in the form of copay cards, grants, and free drug applications.
• Working closely with providers and third parties to reduce the cost hurdles associated with specialty medications.
• Coordinating with stakeholders to remove medication access barriers.
• Maintaining current knowledge of pharmacy regulations, payer agreements and assistance programs.
• Providing timely medication benefit counseling to patients and hospital staff.
• Ensuring accurate and timely execution of pharmacy projects as required.
• Following policies, procedures and regulatory requirements and performing other work assignments.

Requirements

• Licensed and registered pharmacy technician in the state of practice (Arizona incumbents must provide the AZ Board of Pharmacy Wallet Card at time of hire).
• Minimum of three years of healthcare and/or insurance/third‑party reimbursement experience, including at least one year of technician experience.
• Strong customer service focus and superior problem‑solving abilities.
• Proficiency in Microsoft Word, Excel, network, web‑based and payer applications.
• Ability to anticipate customer requirements and meet those needs in an appropriate and timely manner.
• Ability to prioritize organization requirements and track progress of multiple initiatives.

Qualifications

• Completion of a Pharmacy Technician Certification Program.
• Associate’s or bachelor’s degree in business, healthcare or related field.
• Prior authorization experience in specialty or retail pharmacy.
• Knowledge of commercial, Medicare B, Medicare D and Medicaid pharmacy rules and regulations.
• Experience with McKesson Enterprise, Cerner and Therigy systems.
• Bilingual ability.
• Additional related education and/or experience.

Schedule

Full‑time position, Monday – Friday, 8 AM – 5 PM.