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About the Medication Care Coordination Team

The Medication Care Coordination (MCC) team is a centralized pharmacy team that works closely with insurance companies, treatment providers, clinical, and administrative staff across a variety of care settings to coordinate effective care delivery and revenue cycle integrity for patients receiving infusion services across Corewell Health. MCC team members complete patient benefit investigation, prior authorizations (PA), and navigate coverage complexities including medical necessity requirements, site of care restrictions, and authorization denials/appeals.

Scope of Work

This position is a supportive role for the systems ambulatory clinics. The tasks for this position will include, but are not limited to, completing pre and/or prior authorizations, assisting with patient assistance programs, scheduling patients from provider referrals or other registries, working with insurance companies to review coverages, communicating with patients and clinical staff, and managing parts of the medication use cycle. There will be additional opportunities to think innovatively and collaborate on projects with other departments and within our own department.

+ Pull, transcribe, and organize clinical information from patient charts into third party platforms or navigators.

+ Complete authorization requests in a timely and efficient manor without compromising quality, to ensure patients receive their care as scheduled.

+ Demonstrate the ability to utilize all payer websites to assist verifying patient’s coordination of benefits and authorization requirements.

+ Organize and track data for multiple payer programs and service lines.

+ Communicate positively and effectively with patients, colleagues, and clinic staff.

+ Adhere to all department procedures, guidelines, and standard work with the ability to utilize resources appropriately.

+ Strong Proficiency in Microsoft Applications, such as MS Word, Excel, Outlook, Teams, and OneNote.

+ Epic Proficiency is a very strong Plus.

Qualifications

+ Required High School Diploma or equivalent

+ Preferred Associate's Degree

+ 1 year of relevant experience Retail or Ambulatory Pharmacy Experience Preferred

+ 1 year of relevant experience Prior Authorization Experience or Insurance Navigation Preferred

+ 1 year of relevant experience Epic Experience Preferred

+ LIC-Pharmacist Intern - STATE_MI State of Michigan Upon Hire required Or

+ LIC-Pharmacy Technician Temp - STATE_MI State of Michigan Upon Hire required And

+ LIC-Pharmacy Technician - STATE_MI State of Michigan 90 Days required

+ CRT-Pharmacy Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board Excludes - LIC - Pharmacist Intern 90 Days required Or

+ CRT-Exam for the Certification of Pharmacy Technicians (ExCPT) - NHA National Healthcareer Association Excludes - LIC - Pharmacist Intern 90 Days required

+ Ideal candidate will possess both Full Pharmacy Technician License and National Certification, such as CPhT from PTCB and ExCPT from NHA

+ Ideal candidate will also possess 1+ years of Retail Pharmacy experience and preferably 1+ years of Prior Authorization Experience or Insurance Navigation experience

+ This position will require S trong Proficiency in Microsoft Applications, such as MS Word, Excel, Outlook, Teams, and OneNote

+ Epic Proficiency would be a very strong Plus

How Corewell Health cares for you

+ Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here (https://careers.corewellhealth.org/us/en/benefits-new) .

+ On-demand pay program powered by Payactiv

+ Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

+ Optional identity theft protection, home and auto insurance, pet insurance

+ Traditional and Roth retirement options with service contribution and match savings

+ Eligibility for benefits is determined by employment type and status

Primary Location

SITE - 1810 Wealthy St SE - Grand Rapids

Department Name

Corporate Admin - Medication Care Coordination

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

7:30 a.m. to 5:30 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.