Outreach Eligibility Specialist

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

High school diploma or GED required., 0-1 years of experience as a Pharmacy Technician preferred., Strong computer skills and ability to navigate Electronic Medical Records (EMR) and Pharmacy Dispensing Systems (PDS)., Excellent organizational skills, attention to detail, and interpersonal skills are essential. .

Key responsibilities:

  • Perform benefits investigations to identify patient eligibility for specialty pharmacy services.
  • Document outcomes of investigations clearly in the designated tools.
  • Collaborate with team members to enhance quality patient care and operational efficiency.
  • Participate in process improvement initiatives and recommend changes to enhance productivity.

Shields Health Solutions logo
Shields Health Solutions SME http://shieldsrx.com
501 - 1000 Employees
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Job description

At Shields Health Solutions, we pride ourselves on our culture of inclusion, kindness, acceptance, and the difference we make in patients' lives every day. We are tremendously proud to consistently be certified as a ‘Great Place to Work’ several years in a row; we’ve been recognized as a Fortunes Best Workplaces in Healthcare™, Millennials™, and Women™; and a Becker’s Healthcare Top 150 Workplace.

Patients are at the heart of everything we do. We are committed to improving lives by ensuring seamless access to specialty medications, better health outcomes, and an enhanced care experience. That’s why more health system leaders trust us to deliver personalized support and comprehensive solutions that make specialty pharmacy more accessible for the patients who need it most. Through our proven Shields Performance Platform, we help drive the financial sustainability of health systems while prioritizing best-in-class outcomes that patients deserve. With a team of leaders in specialty pharmacy, a track record of success partnering with over 80 health systems, and an unwavering dedication to measurable results, we empower health systems to transform their specialty pharmacy into a driver of growth—ensuring every patient receives the best possible care.

 

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.

Job Duties:

  • 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.

Skills:

  • 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.

Experience/ Education:

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.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Social Skills
  • Computer Literacy
  • Detail Oriented
  • Self-Motivation
  • Client Confidentiality
  • Reliability

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