Clinical Specialty Liaison (RN)

Brief Description:  

This role serves as a single point of contact for program specific Specialty Pharmacies (SPs), Specialty Distributors (SDs) and/or the manufacturer’s Sales Force.  The Clinical Specialty Liaison (cSL) provides telephonic professional nursing services in support of client funded contracts.  This role also includes telephonic patient support and resource, referral source, data collector and engagement with IB/OB callers including healthcare professionals. Responsible for reviewing, analyzing, identifying, and solving problematic issues and escalations. Provide timely and accurate reconciliation of SP and/or SD dispensing/shipping information, builds and develops strong SP-HUB relationships, and support all activities that facilitate patient access. As applicable, builds and develops strong Sales Force-HUB relationships. Utilize knowledge of specialty pharmacy processes, dispensing patterns and reimbursement issues to effectively detect and investigate potential gaps in care. 

Specific job duties:

• Adhere to principles as stipulated by program specific contractual agreements and company practices.
• Serve as a professional resource for inquiries and collect data, assemble accurate, timely, clear data and complete summary of follow up phone calls, patient inquiries, and outcomes.
• Serve as the primary resource managing the coordination of specialty pharmacies (SP) and specialty distributors (SD) within HUB operations.
• Participate in program specific customer meetings and training sessions. 
• Engage in program specific orientation meetings and demonstrate clinical competency regarding reimbursement, product, and medical records review. 
• Perform special projects and other duties as assigned.
• Conduct teleconferences with each SP/SD.
• Provide ongoing communication with the SPP as needed to manage each patient case.
• Identify complex cases and triages them appropriately to the next level for support.
• Review the exceptions and restatement of SP records and provides support for questions related to the portal (as applicable)
• Serve as a point of escalation concerning prior authorization denials and/or appeals.
• Contracted by manufacturer to work closely with cSL to support and coordinate delivery.
• Coordinate a delivery date for product, pump and supplies from the appropriate SP to coincide with the patient's first day of titration or based on HCP/patient need.  If the SP is unresponsive or refuses, cSL will notify the manufacturer.
• Obtain information for follow up on behalf on the SP.

Desired Skills and Qualifications:

• Minimum- associate degree and professional nursing license 
• Registered Nurse License in good standing in the state in which you work and/or cross-licensed in other states
• Telephonic nursing roles are required to have a Compact State License in eligible states; additionally, employee must be willing to obtain Compact State license at such time as their  state elects to adopt Compact legislation
• Telephonic nursing roles are required to have a California State License and the employee must be willing to obtain additional Single State Licenses upon request. 
• Previous experience in the PBM and/or healthcare industry preferred 
• Proficient in Microsoft Office applications, specifically Excel  
• Ability to handle a fast paced environment 
• Strong written and verbal communication skills 
• Advanced problem solving and trouble-shooting skills 
• Strong attention to detail 
• Strong team building skills and the ability to train other team members 
• Research, analysis, report preparation and documentation skills 
• Demonstrated customer service resolution skills 

Benefits: 

At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally.  

Here are some of the exciting perks UBC offers: 

• Remote opportunities
• Competitive salaries
• Growth opportunities for promotion
• 401K with company match
• Tuition reimbursement Flexible work environment
• Discretionary PTO (Paid Time Off)
• Paid Holidays
• Employee assistance programs  
• Medical, Dental, and vision coverage
• HSA/FSA
• Telemedicine (Virtual doctor appointments)
• Wellness program
• Adoption assistance
• Short term disability
• Long term disability
• Life insurance
• Discount programs

UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients. 

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