JOB SUMMARY & RESPONSABILITIES:
The Infusion Coordinator will be responsible for leading the case management with healthcare providers. This position will support the Pharmacy Director in the programs. Also, will directly interact with customers, partners, medical offices, healthcare providers as needed, to understand and serve their needs.
Responsibilities include, but are not limited to the following:
In charge of the Oncall service to bring continuity on business operations.Coordinate cases with hospitals, social workers, business partners and medical offices.Dispensing and processing prescriptions.Coverage Authorization Management.HCpCs Code identification.Manage contract agreements with business partners.Manage authorizations.Manage Payment agreements.Any other duties assigned as part of her role and operations.REQUIRED PROFESSIONAL EXPERIENCE & PROFESSIONAL COMPETENCIES:
Education and Experience:
Associate Degree as Pharmacy Technician. Prime Rx Pharmacy Platform knowledge. (preferred)At least 1-2 years’ experience Infusion Pharmacy (Preferred)Required Skills:
Proficient with Microsoft Office applications and Internet experience.Must be able to communicate effectively (read, speak, and write) in English and Spanish. (preferred)Attention to detail; organizational skills; interpersonal and customer service skills.Demonstrated ability to effectively collaborate and work as part of a team.EEOC F/M/D/V
JOB SUMMARY & RESPONSABILITIES:
The pharmacy delivery courier is responsible for delivery of medications to the patient’s home, complying with the provisions of the law and corporate standards.
Responsibilities include, but are not limited to the following:
Always ensure the safety and integrity of medications. Including temperature parameters for medications that require it.Protect the patient's health information by avoiding leaving medicine packages unattended and identifying the people to whom they are delivered.Call the patient and / or authorized representative to notify the delivery.Call the patient and / or authorized representative to clarify doubts about how to get to or access the home.Receive items and documents for transport from a company to another one and ensure that the items are safely transported to their destinations.Maintain contact with the pharmacy or supervisor to ensure that he or she is made aware of delivery or transport situation.Perform daily inspections on all assigned vehicles, at the beginning of each shift.Ensure that all cars are properly cleaned and maintained and that any need for repairs is outlined and reported.REQUIRED PROFESSIONAL EXPERIENCE & PROFESSIONAL COMPETENCIES:
Education and Experience:
High School Diploma or equivalent.Required Skills:
Excellent communication at all levels, including but not limited to physicians, office staff, patients, and their caregivers.Able to work effectively with limited supervision.Initiative, dedication, multitasking and teamwork.Medical, clinical knowledge and focused customer service preferable.Must be able to communicate effectively (read, speak, and write) in Spanish. The ability to communicate also in English is preferred.Must have a valid driver's license***EEOC F/M/D/V***
Read LessEl Coordinador(a) de Infusión será responsable de liderar la gestión de casos con proveedores de servicios de salud. Este puesto apoyará al Director de Farmacia en los programas y también interactuará directamente con clientes, socios, consultorios médicos y proveedores de salud, según sea necesario, para comprender y atender sus necesidades.
Las responsabilidades incluyen, pero no se limitan a, las siguientes:
Estar a cargo del servicio On Call para garantizar la continuidad de las operaciones del negocio.Coordinar casos con hospitales, trabajadores sociales, socios comerciales y consultorios médicos.Dispensar y procesar recetas médicas.Manejo de autorizaciones de cubierta (Coverage Authorization Management).Identificación de códigos HCPCS.Administrar acuerdos contractuales con socios comerciales.Gestionar autorizaciones.Administrar acuerdos de pago.Cualquier otra responsabilidad asignada como parte de su rol y de las operaciones.EXPERIENCIA PROFESIONAL REQUERIDA Y COMPETENCIAS:Educación y Experiencia:Grado Asociado como Técnico(a) de Farmacia.Conocimiento de la plataforma farmacéutica Prime Rx (preferido).Al menos de 1 a 2 años de experiencia en Farmacia de Infusión (preferido).Habilidades Requeridas:Dominio de las aplicaciones de Microsoft Office y experiencia en el uso de Internet.Capacidad para comunicarse efectivamente (leer, hablar y escribir) en inglés y español (preferido).Atención al detalle; habilidades organizacionales, interpersonales y de servicio al cliente.Capacidad demostrada para colaborar de manera efectiva y trabajar como parte de un equipo.EEOC F/M/D/V
Read LessSummary:
The Clinical Nurse Manager Associate is responsible for performing telephonic contact with patients of Alivia Infusion Services in order to monitor the evolution of the patient’s conditions. He or she will evaluate the health care and educational needs of the patients regarding medications and will communicate recommendations to the clinical pharmacists as necessary. Among other duties, the Clinical Nurse Manager Associate will ensure patient’s understanding of medication regimens and will recognize and provide next steps for patients reporting adverse reactions or concerns with medications. From time to time, the Clinical Nurse Manager Associate may be required to conduct some field work to visit HCP’s and Patients or to accompany Management in carrying out some work-related activities.
Requirements:
2 years of experience in patient nursing and/or direct patient care is preferred.Advanced demonstrated interpersonal/verbal communication skills.Ability to multi-task.Ability to effectively create reports and present information and respond to questions from families, patients, providers, peers, and management.Ability to create, review and interpret treatment plans.Demonstrated time management and priority setting skills.Knowledge and experience in the areas of Antibiotics and Specialty Drugs.Must be bilingual in English and Spanish.***Equal Opportunity Employer F/M/V/D/S/A***
Summary:
The Clinical Nurse Manager Associate is responsible for performing telephonic contact with patients of Alivia Infusion Services in order to monitor the evolution of the patient’s conditions. He or she will evaluate the health care and educational needs of the patients regarding medications and will communicate recommendations to the clinical pharmacists as necessary. Among other duties, the Clinical Nurse Manager Associate will ensure patient’s understanding of medication regimens and will recognize and provide next steps for patients reporting adverse reactions or concerns with medications. From time to time, the Clinical Nurse Manager Associate may be required to conduct some field work to visit HCP’s and Patients or to accompany Management in carrying out some work-related activities.
Requirements:
2 years of experience in patient nursing and/or direct patient care is preferred.Advanced demonstrated interpersonal/verbal communication skills.Ability to multi-task.Ability to effectively create reports and present information and respond to questions from families, patients, providers, peers, and management.Ability to create, review and interpret treatment plans.Demonstrated time management and priority setting skills.Knowledge and experience in the areas of Antibiotics and Specialty Drugs.Must be bilingual in English and Spanish.***Equal Opportunity Employer F/M/V/D/S/A***
Location: Guaynabo, PR
PBM Claims Analyst is responsible for auditing, analyzing, and tracking accounts receivable related to Pharmacy Benefit Managers (PBMs) at a specialty pharmacy. This role focuses primarily on reviewing and validating payments, identifying discrepancies, and analyzing unpaid payments. The analyst’s primary responsibility is to audit, document, and report findings to the teams.
Responsibilities:
Conduct daily audits of PBM-related accounts receivable to identify outstanding balances.Analyze claims that have been paid, partially paid, or unpaid, as processed in “View Response.”Review PBM remittances, reports, and electronic files to verify the accuracy of payments.Identify discrepancies between amounts billed, amounts paid, and contractually expected amounts.Clearly and thoroughly document audit findings in the established systems.Refer cases of errors, partial payments, or required adjustments to the Operations team.Follow up on referred cases until resolution, without performing reprocessing.Prepare lists and reports of audited and referred PBM accounts and discuss them with your Supervisor.Identify recurring patterns of errors, delays, or non-compliance by PBMs.Communicate financial trends and risks to the appropriate Supervisor or Manager.Support internal and external audits related to PBM accounts receivable.Requirements:
Associate's degree in Medical Billing and Coding, Health Services Administration, Medical Office Administration, Medical Records, or related fields in the healthcare sector.***Equal Opportunity Employer M/F/V/D**
Read LessUbicación: Guaynabo, PR
El Analista de Auditoría PBM es responsable de auditar, analizar y dar seguimiento a las cuentas por cobrar relacionadas con Pharmacy Benefit Managers (PBM) en una farmacia especializada. Este rol está enfocado principalmente en la revisión y validación de pagos, identificación de discrepancias, análisis deo pagos no recibidos. Su función principal es auditar, documentar y referir hallazgos a los equipos.
Responsabilidades:
Auditar diariamente las cuentas por cobrar relacionadas con PBM para identificar balances pendientes.Analizar reclamaciones pagadas, parcialmente pagadas o no pagadas; según lo procesado en el “View Response”.Revisar remesas, reportes y archivos electrónicos de PBM para validar exactitud de los pagos.Identificar discrepancias entre lo facturado, lo pagado y lo esperado contractualmente.Documentar de forma clara y detallada los hallazgos de auditoría en los sistemas establecidos.Referir casos de errores, pagos parciales o ajustes requeridos al equipo Operaciones.Dar seguimiento a los casos referidos hasta su resolución, sin ejecutar el reprocesamiento.Preparar listados y reportes de cuentas PBM auditadas y referidas y discutirlo con su Supervisor.Identificar patrones recurrentes de errores, retrasos o incumplimientos por parte de los PBM.Comunicar tendencias y riesgos financieros al Supervisor o Gerente correspondiente.Apoyar auditorías internas y externas relacionadas con cuentas por cobrar PBM.
Requisitos:
***Patrono con Igualdad de Oportunidades de Empleo M/H/V/I***
Read LessThe Sales Specialist will develop, maintain and expand sales and Alivia’s brand recognition in a designated territory assignment managing specifics therapeutic areas prioritized by Alivia. They deliver balanced sales presentations to a defined list of current and prospective customers with a defined frequency. In the assigned territory, the Sales Specialist will utilize all marketing and selling materials designed for a respective audience. They engage in effective business planning, calling on customers who may include, but are not limited to, physicians, nurses, healthcare providers, retail/wholesale accounts, and hospitals/clinics. This role has the primary responsibility of adding new customers to Alivia Specialty by establishing contact with potential new customers. Remain current with market knowledge of the Specialty Pharmacy business and the assigned Therapeutic Areas and specialists. The Sales Specialist will function independently with a high degree of territory and business development proficiency to drive sales performance.
Responsibilities include but are not limited to:
Establecer y mantener relaciones comerciales sólidas con los profesionales sanitarios clave en las áreas terapéuticas asignadas.Alcanzar todos los objetivos y metas de rendimiento de ventas para el territorio asignado.Elaborar presentaciones de ventas exhaustivas y precisas utilizando todos los materiales de marketing y ventas aprobados.Aprovechar la experiencia y los conocimientos sobre el negocio de las farmacias especializadas para anticipar y gestionar eficazmente las oportunidades de negocio dentro del territorio y las áreas terapéuticas asignadas.Mantener un conocimiento profundo de las patologías asignadas y de los productos clave promocionados dentro del segmento. Realizar presentaciones de ventas eficaces a una lista definida de clientes actuales y potenciales con una frecuencia basada en los objetivos de visitas asignados.Required:
BBA or MBAAt least 3-5 years of experience in Specialty Pharmacy or Pharmaceutical Sales***EEOC F/M/D/V***
El especialista en ventas se encargará de desarrollar, mantener y ampliar las ventas y el reconocimiento de la marca Alivia en un territorio asignado, gestionando las áreas terapéuticas específicas prioritarias para Alivia. Realizará presentaciones de ventas equilibradas a una lista definida de clientes actuales y potenciales con una frecuencia determinada. En el territorio asignado, el especialista en ventas utilizará todos los materiales de marketing y venta diseñados para el público respectivo. Se dedicará a una planificación comercial eficaz, visitando a clientes que pueden incluir, entre otros, médicos, enfermeros, profesionales sanitarios, cuentas minoristas/mayoristas y hospitales/clínicas. Esta función tiene como responsabilidad principal la captación de nuevos clientes para Alivia Specialty mediante el establecimiento de contacto con nuevos clientes potenciales. Mantenerse al día con el conocimiento del mercado del negocio de la farmacia especializada y de las áreas terapéuticas y especialistas asignadas. El especialista en ventas trabajará de forma independiente con un alto grado de competencia en el desarrollo del territorio y del negocio para impulsar el rendimiento de las ventas.
Responsabilidades:
Establecer y mantener sólidas relaciones comerciales con especialistas clave en atención sanitaria en las áreas terapéuticas asignadas. Alcanzar todas las metas y objetivos de rendimiento de ventas para la asignación geográfica (territorio).Elaborar presentaciones de ventas exhaustivas y precisas utilizando todos los materiales de marketing y venta aprobados.Aprovechar la experiencia y los conocimientos del negocio de las farmacias especializadas para anticipar unRequisitos:
Bachillerato en Administración de Empresas (BBA) o Máster en Administración de Empresas (MBA)Al menos entre 3 y 5 años de experiencia en farmacias especializadas o en ventas farmacéuticas Read LessLocation: Guaynabo
Responsibilities:
Creation of invoices for managed medicalplans;including but not limited to: FM Medical Vital,MenonitaVital, Triple S (All LOB), Humana, MMM, MCS; among others.Creation of invoices for secondary medical plans and foundations.Handling anduse ofbilling programs.Bill within the required time and in the correct manner.Responsible for the electronic transmission or sending of paper invoices and for accepting and confirming transmitted invoices.Responsible for reviewing, analyzing, and correcting invoices rejected in transmission.Meet the productivity and metricsestablishedin the monthly work plans.Meet the monthly billing close.In charge of investigating and resolving billing problems and referring them to theSupervisor;if necessary.Contact medical offices, patients, and medicalplans;if necessary.Update medical plan circulars.Have up-to-date medical plan rate charts.File sent invoices on paper and deactivate paid cases.Assisting the preparation of patient payment agreements, quotes, or proof of receipt.Required:
High school diploma.Medical Billing Certification. (preferred) or equivalent to 2 years of billing experience.Continuing Education Certificates in the area of billing. (preferred) Read Less