Partner Program Coordinator

KPH Healthcare ServicesGouverneur, NY
2d

About The Position

Overview Scope of Responsibilities: Provide guidance, assistance and expertise regarding specialty assistance programs between ProAct and contract pharmacies to include Noble Health Services and other specialty and/or retail pharmacies. Coordinate with all appropriate parties to secure funding assistance, medication shipment and regularly communicate updates on member-specific cases. Works under direct supervision and follows standard procedures to accomplish assigned tasks. Job Summary: Responsible for coordinating functions related to specialty assistance programs to include, but not limited to ProActPLUS and other external copay sourcing program related operations on a day-to-day basis. Act as the liaison between ProAct, and Noble Health Services (or other network pharmacies) to support these programs and its components.

Requirements

  • Strong Communication Skills, must be able to effectively communicate both on the phone and in email setting
  • Strong PC Skills, will be using multiple different PC programs
  • Must be able to work independently
  • Drug test
  • Initial and continuous exclusion and sanction/disciplinary monitoring
  • Any and all additional eligibility requirements based on the specific position
  • HIPPA Privacy Course and CE Mastery Exam
  • HIPPA Security Course and CE Mastery Exam
  • Successful completion of a pre-employment and/or random drug screening test
  • Customer Service: Must provide timely and accurate responses to all business associates and customers
  • Organization: Must organize work in a systematic way, establish clear lines of responsibility, and delegate effectively
  • Communication: Must write and speak clearly and effectively at all levels, listen and be attentive to others
  • Technology: Must use technology to its fullest potential to achieve department and corporate goals
  • Flexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure

Nice To Haves

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

Responsibilities

  • Support ProAct clients and members regarding functions related to specialty assistance programs.
  • Partner with Noble Health Services and other network pharmacies on the administration of ProAct-owned programs such as ProActPLUS as well as third party solutions and other utilization management programs.
  • Perform outreach to physician offices and members to request prescriptions, confirm assistance components, etc.
  • Process overrides in ProAct’s processing database to ensure claims are processing as intended after funding is secured.
  • Assist Noble and other network pharmacies with various other ProAct-related inquiries or overrides that need to be entered for successful claim processing.
  • Complete all mandatory KPH, state, and federal training programs.
  • Perform other duties as assigned.
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