What are the responsibilities and job description for the Outreach Eligibility Specialist position at Shields Health Solutions?
At Shields, we pride ourselves on our culture of inclusion and kindness and the difference we make in patients' lives every day. We are tremendously proud to be certified as a ‘Great Place to Work’ four years in a row. In 2022, we were awarded US Fortune Best Workplaces in Health Care™, Fortune Best Workplaces for Millennials™ & Fortune Best Workplaces for Women™.
Improving lives and elevating performance are at the heart of everything we do. That’s why more health system leaders trust Shields to elevate access, outcomes and growth within specialty pharmacy — delivering value throughout the entire health system. Leveraging our proven Shields Performance Platform – we deliver the financial results that health systems demand and the superior outcomes patients deserve. With the foremost leaders in specialty pharmacy on our team; proven success partnering with more than 70 health systems; and a vested interest in delivering measurable results – we are the partner health systems trust to transform their specialty pharmacy into a powerful growth engine and elevate performance where it matters most.
Job Purpose:
Required Licensure/Certification: We are seeking experienced pharmacy technicians. Nationally certified from PTCB or equivalent is strongly preferred but not required. State license is preferred but not required. Dependent on hospital placement you may be required to become state certified. Should licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements.
Years of Experience: 0-1 years' experience as a Pharmacy Technician.
Required Education: High school diploma or GED.
California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.
Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Improving lives and elevating performance are at the heart of everything we do. That’s why more health system leaders trust Shields to elevate access, outcomes and growth within specialty pharmacy — delivering value throughout the entire health system. Leveraging our proven Shields Performance Platform – we deliver the financial results that health systems demand and the superior outcomes patients deserve. With the foremost leaders in specialty pharmacy on our team; proven success partnering with more than 70 health systems; and a vested interest in delivering measurable results – we are the partner health systems trust to transform their specialty pharmacy into a powerful growth engine and elevate performance where it matters most.
Job Purpose:
- Proactively grow the specialty pharmacy patient population by identifying patients that are eligible to fill with a Shields Partner Pharmacy.
- Complete patient benefits investigations.
- Protect Shields values by keeping information confidential.
- Perform benefits investigation.
- Utilize multiple approved tools to identify insurance coverage.
- Research within patients' medical records for current medication regimen.
- Complete benefits investigation with approved Pharmacy Dispensing Systems.
- Document clearly and concisely all outcomes of benefits investigation in documentation tool.
- Collaborate with team members to provide an integrated approach of quality patient care.
- Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.
- Identify trends, resolve problems; recommend improvements; implement change.
- Actively participate in process improvement initiatives.
- Act as a value-added business partner to stakeholders throughout the organization.
- Protect organization's values by keeping information confidential.
- Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
- Other duties as assigned.
- We are looking for someone with strong computer skills and the ability to quickly learn to navigate Electronic Medical Records (EMR) and Pharmacy Dispensing Systems (PDS).
- The applicant should be very organized self-motivated with attention to detail and have great interpersonal skills, high integrity and be dependable.
- The ideal candidate will be an energetic and highly motivated, team player with a willingness to do whatever is necessary for the betterment of the company. Discretion and confidentiality are essential as position deals with highly sensitive and private data.
Required Licensure/Certification: We are seeking experienced pharmacy technicians. Nationally certified from PTCB or equivalent is strongly preferred but not required. State license is preferred but not required. Dependent on hospital placement you may be required to become state certified. Should licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements.
Years of Experience: 0-1 years' experience as a Pharmacy Technician.
Required Education: High school diploma or GED.
California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.
Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
