Outreach Eligibility Specialist

As an Outreach Eligibility Specialist at Shields, you will be responsible for proactively growing the specialty pharmacy patient population by identifying patients eligible to fill prescriptions at partner pharmacies. Your main duties include conducting thorough benefits investigations, utilizing various tools to determine insurance coverage, and documenting the outcomes clearly. Collaboration with team members to ensure integrated quality patient care is also an essential part of your role.

To qualify for the Outreach Eligibility Specialist position at Shields, candidates should ideally have a high school diploma or GED, with 0-1 years of experience as a Pharmacy Technician. National certification from the Pharmacy Technician Certification Board (PTCB) or a state license is preferred but not required. Strong computer skills, attention to detail, and great interpersonal abilities are crucial for success in this role.

An Outreach Eligibility Specialist at Shields should possess strong computer skills, especially in navigating Electronic Medical Records (EMR) and Pharmacy Dispensing Systems (PDS). Additionally, the ability to stay organized, self-motivate, and maintain high interpersonal skills is vital. Discretion and confidentiality are also essential as the position involves handling sensitive patient data.

Shields is committed to the professional growth of its Outreach Eligibility Specialists by encouraging participation in educational opportunities and providing resources to keep job knowledge updated. Sharing insights from professional publications and being part of professional organizations are also promoted. This supportive culture fosters continuous learning and career advancement.

The workplace culture at Shields is one of inclusion and kindness, greatly contributing to its recognition as a ‘Great Place to Work.’ With accolades from Fortune for Best Workplaces in Health Care and for Women, the environment encourages collaboration, innovation, and personal development. Outreach Eligibility Specialists work in a supportive setting where they are valued for their contributions to patient care.

In your response, focus on any relevant experience with patient eligibility investigations or similar tasks. Highlight processes you followed for collecting and analyzing patient data to determine insurance coverage and explain how you document findings. If you lack direct experience, discuss how your skills in organization and attention to detail will help you excel in conducting these investigations.

Discuss your understanding of HIPAA regulations and the importance of discretion when working with sensitive patient information. Mention specific practices you follow, such as limiting information access, using secure communication methods, and maintaining accurate records securely. Demonstrating your commitment to confidentiality will reassure interviewers of your integrity.

When answering this question, mention any specific Electronic Medical Records (EMR) or Pharmacy Dispensing Systems (PDS) you have experience with. If you do not have direct experience, emphasize your ability to learn quickly and adapt to new technologies. Offer examples of similar systems you've used in the past.

Explain your approach to communicating with patients compassionately while providing clear information on their options. Highlight your problem-solving skills by discussing how you would research alternative solutions or navigate the appeals process to assist patients in accessing their medications.

Share a specific example that showcases your teamwork skills. Describe the goal, your role in the collaboration, and how you worked with others to achieve success. Ensure you focus on the importance of communication and how working as part of a team contributes to quality patient care.

Discuss your passion for helping others and improving patient outcomes. You may mention your desire to contribute to a positive healthcare experience for patients who rely on specialty pharmacy services. Personal stories or experiences can make your motivation genuine and relatable.

Describe your organizational skills and how you plan your workload. Mention tools or methods you use to prioritize tasks based on urgency and importance, ensuring that patient needs are addressed promptly. Your ability to manage time effectively is crucial in this role.

Identify a challenge, such as high caseloads or complex eligibility criteria, and provide thoughtful strategies for overcoming it. Mention your proactive approach to problem-solving and your willingness to seek feedback or collaborate with colleagues to improve processes.

Discuss your commitment to continuous learning through attending workshops, subscribing to relevant publications, or being active in professional organizations. Highlight how staying informed allows you to apply best practices in your role as an Outreach Eligibility Specialist.

Express your admiration for Shields' commitment to patient care and their recognition as a great workplace. Highlight any research you've done about their values and mission, and explain how they align with your personal beliefs and career aspirations in healthcare.