Scope of Responsibilities: Provide guidance, assistance, and expertise regarding specialty and copay 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. Relies on experience and training to serve as the support coordinator for the team for day-to-day questions. Works under direct supervision and follows standard procedures to accomplish assigned tasks.

Job Summary: Responsible for coordinating functions related to patient and copay 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. Work directly with our external partners to ensure successful administration of the ProActPLUS program and all components.

• Support ProAct clients and members regarding functions related to specialty assistance programs.
• Responsible for being a leader and support person for the team of partner program coordinators.
• 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.
• Assist Noble and other network pharmacies with various other ProAct-related inquiries or overrides that need to be entered for successful claim processing.
• Responsible for new client monitoring for the first 30-60 days post go live.
• Responsible for assisting in the managing of the partner program process for ProAct members, including administrative responsibilities related to reporting, reconciliation, and invoicing.
• Responsible for supporting other ProAct departments and/or team members as a partner program resource and trainer, including but not limited to implementation, benefit operations, marketing, sales, account management, accounting, and proposal departments with regular touch points.
• Perform outreach (phone, fax, mail) to complete cost avoidance interventions, including but not limited to leveraging the following software and programs: Enterprise, PA Hub/PromptPA, McKesson APS Adherence, ProAct’s adjudication platform, and CRM.
• Perform outreach to physician offices and members to request prescriptions, prior authorizations, and confirm assistance components.
• Process overrides in ProAct’s adjudication platform to ensure claims are processing as intended after funding is secured.
• Work directly with other ProAct departments to solve for member issues, answer questions specific to available funding options, and provide status updates on members and funding.
• Support meetings with our external partners as the voice of the partner program coordinators
• Assist with creating and maintaining new hire training materials and team policy & procedures.
• Assist with the training and onboarding process for new hires.
• Complete all mandatory KPH, state, and federal training programs.
• Perform other duties as assigned.

Experience Preferred:

• Preferred: 2 years’ experience with health care, insurance and/or project management

Job Skills Required:

• Strong Communication Skills, must be able to effectively communicate both on the phone and in group setting
• Strong PC Skills, will be using multiple different PC programs
• Clinical Research Skills, must be able to use all available resources to answer question from clients
• Strong Microsoft skills in Smartsheet, Excel, and Word
• Must be able to work independently

Compensation:

$21.50 - 22.50 per hour.

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.  

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.