Specialty Pharmacy A Complete Guide
You're facing pressure like never before. Regulatory changes, complex reimbursement models, and high-cost therapies are reshaping the pharmacy landscape - and if you're not ahead of the curve, you're already falling behind. General pharmacy knowledge isn't enough anymore. Specialty medications now represent over 50% of drug spending in the US, and demand for professionals who can navigate this space with precision is exploding. But without a clear roadmap, you're left guessing what to prioritise, how to scale efficiently, and how to stand out in a field where mistakes cost time, revenue, and patient trust. Specialty Pharmacy A Complete Guide is your proven blueprint to go from overwhelmed to authoritative - transforming uncertainty into confidence with a step-by-step system trusted by pharmacists, pharmacy managers, and clinical coordinators across integrated health systems and independent practices. This isn’t theoretical. One learner, Maria S., a clinical pharmacy specialist in Florida, used this course to redesign her health system’s patient onboarding process, cutting average initiation time by 38% and reducing insurance denial rates within 90 days of launch. She now leads training for other sites across the network. You don’t need more information. You need the right framework - one that prioritises compliance, patient outcomes, reimbursement integrity, and operational efficiency in one cohesive strategy. Here’s how this course is structured to help you get there.Immediate, Risk-Free Access With Guaranteed Results Enroll today and gain immediate online access to the full curriculum. This course is fully self-paced, with no mandatory deadlines or time commitments, so you move at the speed of your priorities. Most learners complete the core content in 3–5 weeks while applying key concepts directly to their roles. Many report identifying at least one operational gap or revenue recovery opportunity within their first 72 hours of starting. Lifetime Access, Future-Proof Learning
Once enrolled, you receive lifetime access to all materials, including every future update at no additional cost. The specialty pharmacy field evolves rapidly, and your access evolves with it. All content is mobile-friendly and accessible 24/7 from any device - whether you're reviewing protocols on-site, preparing for audits, or leading team huddles. Direct Expert Guidance & Trusted Certification
You are not learning in isolation. This course includes structured guidance pathways with clarity-driven support designed to keep you moving forward. Every module is built around best practices validated by pharmacy operations leaders and accreditation experts. Upon completion, you will earn a verifiable Certificate of Completion issued by The Art of Service - a globally recognised credential trusted by healthcare employers, consultants, and regulatory advisors. This certificate demonstrates your mastery of specialty pharmacy systems and positions you as a leader in high-acuity medication management. No Risk. Full Confidence.
We eliminate every barrier to your success. Our pricing is transparent with no hidden fees. We accept Visa, Mastercard, and PayPal - all processed securely. Enroll with complete peace of mind. If you’re not satisfied with the value you receive, return the completed materials for a full refund under our 100% money-back guarantee. Your risk is zero. Your potential ROI is exponential. Designed For Real-World Impact - Regardless of Your Starting Point
This course works even if you’ve never managed a specialty pharmacy program, if your current team lacks standardised workflows, or if you're transitioning from retail or hospital pharmacy. The content is role-adaptive, with applications for pharmacists, pharmacy technicians, reimbursement coordinators, and clinical operations managers. One participant, James T., transitioned from a community pharmacy role into a six-figure specialty operations manager position within four months of finishing - citing the accreditation readiness checklist and financial viability models as key differentiators in his interviews. You will get clear, structured direction even if you work solo, in a small practice, or within a large integrated system. Every tool is designed to scale with your environment. Your Access Path Is Secure and Straightforward
After enrollment, you will receive a confirmation email. Your course access details will be sent separately once your materials are fully prepared, ensuring a smooth and professional onboarding experience. Your investment is protected, your outcomes are prioritised, and your advancement is the mission.
Module 1: Foundations of Specialty Pharmacy - Defining specialty pharmacy: scope, evolution, and market drivers
- Key differences between traditional and specialty pharmacy operations
- Understanding high-cost, high-complexity, and high-touch medications
- Major therapeutic categories: oncology, immunology, neurology, rare diseases
- Role of biologics and advanced therapy medicinal products
- Pharmacist responsibilities in patient monitoring and safety
- Accreditation bodies and their impact on service delivery
- Core stakeholders: payers, manufacturers, providers, patients
- Regulatory landscape: CMS, FDA, DEA, and state board implications
- Patient eligibility criteria and therapy initiation protocols
- Understanding risk evaluation and mitigation strategies (REMS)
- Specialty pharmacy’s role in value-based care models
- Chain of distribution: from manufacturer to patient
- Comparative analysis: hub services vs in-house specialty programs
- Key performance indicators for early-stage specialty programs
Module 2: Regulatory and Compliance Frameworks - CMS Part D specialty drug designation criteria
- DEA scheduling and handling requirements for controlled substances in specialty
- 42 CFR Part 2 and patient privacy in addiction-related therapies
- HIPAA-compliant communication protocols for high-acuity patients
- Accreditation requirements: URAC, The Joint Commission, ACHC
- Maintaining audit readiness for pharmacy licensure renewals
- Conflict of interest policies in manufacturer support programs
- Pharmacy licensure across state lines and multi-state operations
- Handling investigational drugs and expanded access programs
- Documentation standards for patient consent and education
- Compliance with prescriber attestation requirements
- Policies for handling drug shortages and backorders
- Reporting adverse events and medication errors
- Internal compliance audits and corrective action planning
- Billing and coding compliance to avoid overpayment liabilities
Module 3: Patient Intake and Onboarding Systems - Step-by-step patient eligibility verification process
- Best practices for collecting and validating insurance information
- Designing efficient intake workflows for high-volume therapies
- Standardised patient consent forms and compliance checklists
- Initial clinical assessment templates for condition-specific therapies
- Coordinating with prescribers for treatment authorisation
- Automating intake with digital forms and secure portals
- Role of pharmacy technicians in pre-verification workflows
- Creating patient welcome packets and education calendars
- Setting expectations for medication delivery and follow-up
- Identifying social determinants of health during intake
- Integrating language access and health literacy tools
- Tracking time-to-treatment initiation as a KPI
- Handling incomplete or conflicting prescriber orders
- Escalation protocols for urgent therapy starts
Module 4: Insurance Verification and Benefit Investigation - Understanding medical vs pharmacy benefit split for specialty drugs
- Conducting comprehensive benefit investigations (BI)
- Interpreting Explanation of Benefits (EOB) documents
- Identifying co-insurance, deductibles, and out-of-pocket maximums
- Navigating Medicare Secondary Payer (MSP) rules
- Checking prior authorization (PA) requirements by payer
- Identifying step therapy and fail-first policy triggers
- Using real-time eligibility tools and payer portals
- Documenting benefit findings in patient records
- Communicating financial responsibility clearly to patients
- Calculating net cost after copay assistance eligibility
- Identifying specialty pharmacy network requirements
- Handling commercial, Medicare Part D, and Medicaid plans
- Working with Tricare, FEHB, and other federal programs
- Updating insurance information during treatment cycles
Module 5: Prior Authorization and Clinical Documentation - Building a library of payer-specific PA forms and templates
- Determining clinical criteria for medical necessity
- Writing effective clinical letters of medical necessity
- Gathering required lab results, imaging reports, and progress notes
- Collaborating with prescribers to obtain supporting documentation
- Submitting PA requests via electronic, fax, and portal methods
- Tracking PA status with shared dashboards
- Responding to requests for additional information
- Appealing denials with structured clinical arguments
- Understanding turnaround times for different payers
- Using peer-to-peer review to resolve complex cases
- Standardising PA workflows across team members
- Reducing PA cycle time with automation tools
- Maintaining audit-ready PA documentation
- Measuring PA approval rates by drug and payer
Module 6: Financial Assistance and Copay Support Programs - Locating manufacturer copay cards and foundation assistance programs
- Eligibility verification for patient support programs
- Enrolling patients in foundation grants and charitable aid
- Submitting applications with complete, error-free documentation
- Tracking application status and follow-up timelines
- Understanding program restrictions and income thresholds
- Managing dual assistance: foundation + copay card coordination
- Handling denied or expired assistance applications
- Communicating financial options without causing patient distress
- Integrating financial counseling into patient care plans
- Training staff on empathy-based financial conversations
- Documenting patient consent for third-party program participation
- Monitoring fund availability for trending therapies
- Alerting patients to upcoming assistance renewals
- Preparing backup funding strategies for therapy continuity
Module 7: Medication Fulfilment and Logistics - Validating prescription accuracy before dispensing
- Temperature-sensitive packaging and cold chain logistics
- Shipping methods: overnight, white glove, and in-person delivery
- Signature requirements and adult confirmation protocols
- Tracking shipment status and delivery confirmation
- Handling delivery failures and redelivery scheduling
- Inventory management for high-cost, low-turnover medications
- Reconstituting and preparing injectable therapies safely
- Dosing accuracy checks and pharmacist verification steps
- Labelling requirements for specialty medications
- Developing emergency dispensing protocols
- Managing partial vial use and waste documentation
- Coordinating with home health nurses for administration support
- Handling patient self-administration training needs
- Creating pharmacist sign-off checklists for each shipment
Module 8: Patient Education and Adherence Support - Developing condition-specific patient education modules
- Teaching proper storage and handling of temperature-sensitive drugs
- Reviewing injection techniques and self-administration steps
- Recognising and managing common side effects
- Providing medication guides and illustrated instructions
- Scheduling structured touchpoints during treatment
- Using teach-back methods to confirm understanding
- Creating personalised adherence calendars
- Addressing fears or misconceptions about therapy risks
- Integrating mental health screening into adherence plans
- Identifying adherence barriers: cost, complexity, stigma
- Setting up reminder systems: SMS, phone, email
- Motivational interviewing techniques for resistant patients
- Documenting patient understanding in clinical records
- Transitioning patients to maintenance therapy phases
Module 9: Clinical Monitoring and Safety Surveillance - Designing lab monitoring schedules by therapy type
- Tracking adverse events and medication reactions
- Establishing escalation protocols for severe side effects
- Coordinating with prescribers for dose adjustments
- Managing drug-drug and drug-disease interactions
- Monitoring for immunogenicity and loss of response
- Tracking patient-reported outcomes and symptom changes
- Using standardised assessment tools (PROMs, PHQ-9, etc.)
- Scheduling routine clinical follow-ups at defined intervals
- Reporting to registries and post-marketing surveillance
- Documenting clinical interventions and outcomes
- Managing long-term safety for chronic therapies
- Identifying red flags that require immediate action
- Creating clinician handoff templates for care transitions
- Integrating pharmacist recommendations into treatment plans
Module 10: Reimbursement and Billing Operations - Understanding J-codes and HCPCS coding for injectables
- Billing under the pharmacy vs medical benefit
- Submitting claims with appropriate modifiers and line items
- Handling rejected claims and remittance advice review
- Calculating acquisition cost and reimbursement margins
- Managing chargeback systems for distributor contracts
- Reporting revenue and cost data for financial analysis
- Conducting payer contract reviews for profitability
- Maximising reimbursement through coding accuracy
- Handling Medicaid rebate reporting requirements
- Managing Medicare Part B and D billing rules
- Tracking average sales price (ASP) and WAC fluctuations
- Analysing gross-to-net revenue gaps
- Using billing audits to catch underpayment patterns
- Training staff on compliance-conscious billing practices
Module 11: Data Management and Reporting - Designing patient databases with structured fields
- Protecting data integrity and preventing duplication
- Generating reports on therapy start rates and persistence
- Analysing denial and appeal success metrics
- Tracking patient outcomes against clinical goals
- Measuring time-to-fill and cycle time efficiency
- Creating dashboards for operational leadership
- Exporting data for accreditation documentation
- Integrating with EMR and EHR systems where applicable
- Using data to justify program expansion
- Monitoring adherence rates by drug class and payer
- Reporting on financial assistance utilisation
- Identifying trends in patient complaints or barriers
- Automating routine reporting cycles
- Ensuring compliance with data retention policies
Module 12: Accreditation and Quality Improvement - Preparing for URAC Specialty Pharmacy accreditation
- Meeting The Joint Commission outpatient pharmacy standards
- Documenting policies and procedures for audit review
- Conducting mock surveys and gap assessments
- Implementing continuous quality improvement (CQI) cycles
- Analysing root causes of operational failures
- Setting measurable quality goals and tracking progress
- Gathering patient satisfaction feedback systematically
- Training staff on accreditation expectations
- Developing emergency preparedness and business continuity plans
- Validating staff competency in specialty workflows
- Managing vendor credentialing and oversight
- Conducting annual risk assessments
- Submitting required reports to accrediting bodies
- Earning distinction through performance excellence
Module 13: Program Development and Expansion - Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Defining specialty pharmacy: scope, evolution, and market drivers
- Key differences between traditional and specialty pharmacy operations
- Understanding high-cost, high-complexity, and high-touch medications
- Major therapeutic categories: oncology, immunology, neurology, rare diseases
- Role of biologics and advanced therapy medicinal products
- Pharmacist responsibilities in patient monitoring and safety
- Accreditation bodies and their impact on service delivery
- Core stakeholders: payers, manufacturers, providers, patients
- Regulatory landscape: CMS, FDA, DEA, and state board implications
- Patient eligibility criteria and therapy initiation protocols
- Understanding risk evaluation and mitigation strategies (REMS)
- Specialty pharmacy’s role in value-based care models
- Chain of distribution: from manufacturer to patient
- Comparative analysis: hub services vs in-house specialty programs
- Key performance indicators for early-stage specialty programs
Module 2: Regulatory and Compliance Frameworks - CMS Part D specialty drug designation criteria
- DEA scheduling and handling requirements for controlled substances in specialty
- 42 CFR Part 2 and patient privacy in addiction-related therapies
- HIPAA-compliant communication protocols for high-acuity patients
- Accreditation requirements: URAC, The Joint Commission, ACHC
- Maintaining audit readiness for pharmacy licensure renewals
- Conflict of interest policies in manufacturer support programs
- Pharmacy licensure across state lines and multi-state operations
- Handling investigational drugs and expanded access programs
- Documentation standards for patient consent and education
- Compliance with prescriber attestation requirements
- Policies for handling drug shortages and backorders
- Reporting adverse events and medication errors
- Internal compliance audits and corrective action planning
- Billing and coding compliance to avoid overpayment liabilities
Module 3: Patient Intake and Onboarding Systems - Step-by-step patient eligibility verification process
- Best practices for collecting and validating insurance information
- Designing efficient intake workflows for high-volume therapies
- Standardised patient consent forms and compliance checklists
- Initial clinical assessment templates for condition-specific therapies
- Coordinating with prescribers for treatment authorisation
- Automating intake with digital forms and secure portals
- Role of pharmacy technicians in pre-verification workflows
- Creating patient welcome packets and education calendars
- Setting expectations for medication delivery and follow-up
- Identifying social determinants of health during intake
- Integrating language access and health literacy tools
- Tracking time-to-treatment initiation as a KPI
- Handling incomplete or conflicting prescriber orders
- Escalation protocols for urgent therapy starts
Module 4: Insurance Verification and Benefit Investigation - Understanding medical vs pharmacy benefit split for specialty drugs
- Conducting comprehensive benefit investigations (BI)
- Interpreting Explanation of Benefits (EOB) documents
- Identifying co-insurance, deductibles, and out-of-pocket maximums
- Navigating Medicare Secondary Payer (MSP) rules
- Checking prior authorization (PA) requirements by payer
- Identifying step therapy and fail-first policy triggers
- Using real-time eligibility tools and payer portals
- Documenting benefit findings in patient records
- Communicating financial responsibility clearly to patients
- Calculating net cost after copay assistance eligibility
- Identifying specialty pharmacy network requirements
- Handling commercial, Medicare Part D, and Medicaid plans
- Working with Tricare, FEHB, and other federal programs
- Updating insurance information during treatment cycles
Module 5: Prior Authorization and Clinical Documentation - Building a library of payer-specific PA forms and templates
- Determining clinical criteria for medical necessity
- Writing effective clinical letters of medical necessity
- Gathering required lab results, imaging reports, and progress notes
- Collaborating with prescribers to obtain supporting documentation
- Submitting PA requests via electronic, fax, and portal methods
- Tracking PA status with shared dashboards
- Responding to requests for additional information
- Appealing denials with structured clinical arguments
- Understanding turnaround times for different payers
- Using peer-to-peer review to resolve complex cases
- Standardising PA workflows across team members
- Reducing PA cycle time with automation tools
- Maintaining audit-ready PA documentation
- Measuring PA approval rates by drug and payer
Module 6: Financial Assistance and Copay Support Programs - Locating manufacturer copay cards and foundation assistance programs
- Eligibility verification for patient support programs
- Enrolling patients in foundation grants and charitable aid
- Submitting applications with complete, error-free documentation
- Tracking application status and follow-up timelines
- Understanding program restrictions and income thresholds
- Managing dual assistance: foundation + copay card coordination
- Handling denied or expired assistance applications
- Communicating financial options without causing patient distress
- Integrating financial counseling into patient care plans
- Training staff on empathy-based financial conversations
- Documenting patient consent for third-party program participation
- Monitoring fund availability for trending therapies
- Alerting patients to upcoming assistance renewals
- Preparing backup funding strategies for therapy continuity
Module 7: Medication Fulfilment and Logistics - Validating prescription accuracy before dispensing
- Temperature-sensitive packaging and cold chain logistics
- Shipping methods: overnight, white glove, and in-person delivery
- Signature requirements and adult confirmation protocols
- Tracking shipment status and delivery confirmation
- Handling delivery failures and redelivery scheduling
- Inventory management for high-cost, low-turnover medications
- Reconstituting and preparing injectable therapies safely
- Dosing accuracy checks and pharmacist verification steps
- Labelling requirements for specialty medications
- Developing emergency dispensing protocols
- Managing partial vial use and waste documentation
- Coordinating with home health nurses for administration support
- Handling patient self-administration training needs
- Creating pharmacist sign-off checklists for each shipment
Module 8: Patient Education and Adherence Support - Developing condition-specific patient education modules
- Teaching proper storage and handling of temperature-sensitive drugs
- Reviewing injection techniques and self-administration steps
- Recognising and managing common side effects
- Providing medication guides and illustrated instructions
- Scheduling structured touchpoints during treatment
- Using teach-back methods to confirm understanding
- Creating personalised adherence calendars
- Addressing fears or misconceptions about therapy risks
- Integrating mental health screening into adherence plans
- Identifying adherence barriers: cost, complexity, stigma
- Setting up reminder systems: SMS, phone, email
- Motivational interviewing techniques for resistant patients
- Documenting patient understanding in clinical records
- Transitioning patients to maintenance therapy phases
Module 9: Clinical Monitoring and Safety Surveillance - Designing lab monitoring schedules by therapy type
- Tracking adverse events and medication reactions
- Establishing escalation protocols for severe side effects
- Coordinating with prescribers for dose adjustments
- Managing drug-drug and drug-disease interactions
- Monitoring for immunogenicity and loss of response
- Tracking patient-reported outcomes and symptom changes
- Using standardised assessment tools (PROMs, PHQ-9, etc.)
- Scheduling routine clinical follow-ups at defined intervals
- Reporting to registries and post-marketing surveillance
- Documenting clinical interventions and outcomes
- Managing long-term safety for chronic therapies
- Identifying red flags that require immediate action
- Creating clinician handoff templates for care transitions
- Integrating pharmacist recommendations into treatment plans
Module 10: Reimbursement and Billing Operations - Understanding J-codes and HCPCS coding for injectables
- Billing under the pharmacy vs medical benefit
- Submitting claims with appropriate modifiers and line items
- Handling rejected claims and remittance advice review
- Calculating acquisition cost and reimbursement margins
- Managing chargeback systems for distributor contracts
- Reporting revenue and cost data for financial analysis
- Conducting payer contract reviews for profitability
- Maximising reimbursement through coding accuracy
- Handling Medicaid rebate reporting requirements
- Managing Medicare Part B and D billing rules
- Tracking average sales price (ASP) and WAC fluctuations
- Analysing gross-to-net revenue gaps
- Using billing audits to catch underpayment patterns
- Training staff on compliance-conscious billing practices
Module 11: Data Management and Reporting - Designing patient databases with structured fields
- Protecting data integrity and preventing duplication
- Generating reports on therapy start rates and persistence
- Analysing denial and appeal success metrics
- Tracking patient outcomes against clinical goals
- Measuring time-to-fill and cycle time efficiency
- Creating dashboards for operational leadership
- Exporting data for accreditation documentation
- Integrating with EMR and EHR systems where applicable
- Using data to justify program expansion
- Monitoring adherence rates by drug class and payer
- Reporting on financial assistance utilisation
- Identifying trends in patient complaints or barriers
- Automating routine reporting cycles
- Ensuring compliance with data retention policies
Module 12: Accreditation and Quality Improvement - Preparing for URAC Specialty Pharmacy accreditation
- Meeting The Joint Commission outpatient pharmacy standards
- Documenting policies and procedures for audit review
- Conducting mock surveys and gap assessments
- Implementing continuous quality improvement (CQI) cycles
- Analysing root causes of operational failures
- Setting measurable quality goals and tracking progress
- Gathering patient satisfaction feedback systematically
- Training staff on accreditation expectations
- Developing emergency preparedness and business continuity plans
- Validating staff competency in specialty workflows
- Managing vendor credentialing and oversight
- Conducting annual risk assessments
- Submitting required reports to accrediting bodies
- Earning distinction through performance excellence
Module 13: Program Development and Expansion - Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Step-by-step patient eligibility verification process
- Best practices for collecting and validating insurance information
- Designing efficient intake workflows for high-volume therapies
- Standardised patient consent forms and compliance checklists
- Initial clinical assessment templates for condition-specific therapies
- Coordinating with prescribers for treatment authorisation
- Automating intake with digital forms and secure portals
- Role of pharmacy technicians in pre-verification workflows
- Creating patient welcome packets and education calendars
- Setting expectations for medication delivery and follow-up
- Identifying social determinants of health during intake
- Integrating language access and health literacy tools
- Tracking time-to-treatment initiation as a KPI
- Handling incomplete or conflicting prescriber orders
- Escalation protocols for urgent therapy starts
Module 4: Insurance Verification and Benefit Investigation - Understanding medical vs pharmacy benefit split for specialty drugs
- Conducting comprehensive benefit investigations (BI)
- Interpreting Explanation of Benefits (EOB) documents
- Identifying co-insurance, deductibles, and out-of-pocket maximums
- Navigating Medicare Secondary Payer (MSP) rules
- Checking prior authorization (PA) requirements by payer
- Identifying step therapy and fail-first policy triggers
- Using real-time eligibility tools and payer portals
- Documenting benefit findings in patient records
- Communicating financial responsibility clearly to patients
- Calculating net cost after copay assistance eligibility
- Identifying specialty pharmacy network requirements
- Handling commercial, Medicare Part D, and Medicaid plans
- Working with Tricare, FEHB, and other federal programs
- Updating insurance information during treatment cycles
Module 5: Prior Authorization and Clinical Documentation - Building a library of payer-specific PA forms and templates
- Determining clinical criteria for medical necessity
- Writing effective clinical letters of medical necessity
- Gathering required lab results, imaging reports, and progress notes
- Collaborating with prescribers to obtain supporting documentation
- Submitting PA requests via electronic, fax, and portal methods
- Tracking PA status with shared dashboards
- Responding to requests for additional information
- Appealing denials with structured clinical arguments
- Understanding turnaround times for different payers
- Using peer-to-peer review to resolve complex cases
- Standardising PA workflows across team members
- Reducing PA cycle time with automation tools
- Maintaining audit-ready PA documentation
- Measuring PA approval rates by drug and payer
Module 6: Financial Assistance and Copay Support Programs - Locating manufacturer copay cards and foundation assistance programs
- Eligibility verification for patient support programs
- Enrolling patients in foundation grants and charitable aid
- Submitting applications with complete, error-free documentation
- Tracking application status and follow-up timelines
- Understanding program restrictions and income thresholds
- Managing dual assistance: foundation + copay card coordination
- Handling denied or expired assistance applications
- Communicating financial options without causing patient distress
- Integrating financial counseling into patient care plans
- Training staff on empathy-based financial conversations
- Documenting patient consent for third-party program participation
- Monitoring fund availability for trending therapies
- Alerting patients to upcoming assistance renewals
- Preparing backup funding strategies for therapy continuity
Module 7: Medication Fulfilment and Logistics - Validating prescription accuracy before dispensing
- Temperature-sensitive packaging and cold chain logistics
- Shipping methods: overnight, white glove, and in-person delivery
- Signature requirements and adult confirmation protocols
- Tracking shipment status and delivery confirmation
- Handling delivery failures and redelivery scheduling
- Inventory management for high-cost, low-turnover medications
- Reconstituting and preparing injectable therapies safely
- Dosing accuracy checks and pharmacist verification steps
- Labelling requirements for specialty medications
- Developing emergency dispensing protocols
- Managing partial vial use and waste documentation
- Coordinating with home health nurses for administration support
- Handling patient self-administration training needs
- Creating pharmacist sign-off checklists for each shipment
Module 8: Patient Education and Adherence Support - Developing condition-specific patient education modules
- Teaching proper storage and handling of temperature-sensitive drugs
- Reviewing injection techniques and self-administration steps
- Recognising and managing common side effects
- Providing medication guides and illustrated instructions
- Scheduling structured touchpoints during treatment
- Using teach-back methods to confirm understanding
- Creating personalised adherence calendars
- Addressing fears or misconceptions about therapy risks
- Integrating mental health screening into adherence plans
- Identifying adherence barriers: cost, complexity, stigma
- Setting up reminder systems: SMS, phone, email
- Motivational interviewing techniques for resistant patients
- Documenting patient understanding in clinical records
- Transitioning patients to maintenance therapy phases
Module 9: Clinical Monitoring and Safety Surveillance - Designing lab monitoring schedules by therapy type
- Tracking adverse events and medication reactions
- Establishing escalation protocols for severe side effects
- Coordinating with prescribers for dose adjustments
- Managing drug-drug and drug-disease interactions
- Monitoring for immunogenicity and loss of response
- Tracking patient-reported outcomes and symptom changes
- Using standardised assessment tools (PROMs, PHQ-9, etc.)
- Scheduling routine clinical follow-ups at defined intervals
- Reporting to registries and post-marketing surveillance
- Documenting clinical interventions and outcomes
- Managing long-term safety for chronic therapies
- Identifying red flags that require immediate action
- Creating clinician handoff templates for care transitions
- Integrating pharmacist recommendations into treatment plans
Module 10: Reimbursement and Billing Operations - Understanding J-codes and HCPCS coding for injectables
- Billing under the pharmacy vs medical benefit
- Submitting claims with appropriate modifiers and line items
- Handling rejected claims and remittance advice review
- Calculating acquisition cost and reimbursement margins
- Managing chargeback systems for distributor contracts
- Reporting revenue and cost data for financial analysis
- Conducting payer contract reviews for profitability
- Maximising reimbursement through coding accuracy
- Handling Medicaid rebate reporting requirements
- Managing Medicare Part B and D billing rules
- Tracking average sales price (ASP) and WAC fluctuations
- Analysing gross-to-net revenue gaps
- Using billing audits to catch underpayment patterns
- Training staff on compliance-conscious billing practices
Module 11: Data Management and Reporting - Designing patient databases with structured fields
- Protecting data integrity and preventing duplication
- Generating reports on therapy start rates and persistence
- Analysing denial and appeal success metrics
- Tracking patient outcomes against clinical goals
- Measuring time-to-fill and cycle time efficiency
- Creating dashboards for operational leadership
- Exporting data for accreditation documentation
- Integrating with EMR and EHR systems where applicable
- Using data to justify program expansion
- Monitoring adherence rates by drug class and payer
- Reporting on financial assistance utilisation
- Identifying trends in patient complaints or barriers
- Automating routine reporting cycles
- Ensuring compliance with data retention policies
Module 12: Accreditation and Quality Improvement - Preparing for URAC Specialty Pharmacy accreditation
- Meeting The Joint Commission outpatient pharmacy standards
- Documenting policies and procedures for audit review
- Conducting mock surveys and gap assessments
- Implementing continuous quality improvement (CQI) cycles
- Analysing root causes of operational failures
- Setting measurable quality goals and tracking progress
- Gathering patient satisfaction feedback systematically
- Training staff on accreditation expectations
- Developing emergency preparedness and business continuity plans
- Validating staff competency in specialty workflows
- Managing vendor credentialing and oversight
- Conducting annual risk assessments
- Submitting required reports to accrediting bodies
- Earning distinction through performance excellence
Module 13: Program Development and Expansion - Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Building a library of payer-specific PA forms and templates
- Determining clinical criteria for medical necessity
- Writing effective clinical letters of medical necessity
- Gathering required lab results, imaging reports, and progress notes
- Collaborating with prescribers to obtain supporting documentation
- Submitting PA requests via electronic, fax, and portal methods
- Tracking PA status with shared dashboards
- Responding to requests for additional information
- Appealing denials with structured clinical arguments
- Understanding turnaround times for different payers
- Using peer-to-peer review to resolve complex cases
- Standardising PA workflows across team members
- Reducing PA cycle time with automation tools
- Maintaining audit-ready PA documentation
- Measuring PA approval rates by drug and payer
Module 6: Financial Assistance and Copay Support Programs - Locating manufacturer copay cards and foundation assistance programs
- Eligibility verification for patient support programs
- Enrolling patients in foundation grants and charitable aid
- Submitting applications with complete, error-free documentation
- Tracking application status and follow-up timelines
- Understanding program restrictions and income thresholds
- Managing dual assistance: foundation + copay card coordination
- Handling denied or expired assistance applications
- Communicating financial options without causing patient distress
- Integrating financial counseling into patient care plans
- Training staff on empathy-based financial conversations
- Documenting patient consent for third-party program participation
- Monitoring fund availability for trending therapies
- Alerting patients to upcoming assistance renewals
- Preparing backup funding strategies for therapy continuity
Module 7: Medication Fulfilment and Logistics - Validating prescription accuracy before dispensing
- Temperature-sensitive packaging and cold chain logistics
- Shipping methods: overnight, white glove, and in-person delivery
- Signature requirements and adult confirmation protocols
- Tracking shipment status and delivery confirmation
- Handling delivery failures and redelivery scheduling
- Inventory management for high-cost, low-turnover medications
- Reconstituting and preparing injectable therapies safely
- Dosing accuracy checks and pharmacist verification steps
- Labelling requirements for specialty medications
- Developing emergency dispensing protocols
- Managing partial vial use and waste documentation
- Coordinating with home health nurses for administration support
- Handling patient self-administration training needs
- Creating pharmacist sign-off checklists for each shipment
Module 8: Patient Education and Adherence Support - Developing condition-specific patient education modules
- Teaching proper storage and handling of temperature-sensitive drugs
- Reviewing injection techniques and self-administration steps
- Recognising and managing common side effects
- Providing medication guides and illustrated instructions
- Scheduling structured touchpoints during treatment
- Using teach-back methods to confirm understanding
- Creating personalised adherence calendars
- Addressing fears or misconceptions about therapy risks
- Integrating mental health screening into adherence plans
- Identifying adherence barriers: cost, complexity, stigma
- Setting up reminder systems: SMS, phone, email
- Motivational interviewing techniques for resistant patients
- Documenting patient understanding in clinical records
- Transitioning patients to maintenance therapy phases
Module 9: Clinical Monitoring and Safety Surveillance - Designing lab monitoring schedules by therapy type
- Tracking adverse events and medication reactions
- Establishing escalation protocols for severe side effects
- Coordinating with prescribers for dose adjustments
- Managing drug-drug and drug-disease interactions
- Monitoring for immunogenicity and loss of response
- Tracking patient-reported outcomes and symptom changes
- Using standardised assessment tools (PROMs, PHQ-9, etc.)
- Scheduling routine clinical follow-ups at defined intervals
- Reporting to registries and post-marketing surveillance
- Documenting clinical interventions and outcomes
- Managing long-term safety for chronic therapies
- Identifying red flags that require immediate action
- Creating clinician handoff templates for care transitions
- Integrating pharmacist recommendations into treatment plans
Module 10: Reimbursement and Billing Operations - Understanding J-codes and HCPCS coding for injectables
- Billing under the pharmacy vs medical benefit
- Submitting claims with appropriate modifiers and line items
- Handling rejected claims and remittance advice review
- Calculating acquisition cost and reimbursement margins
- Managing chargeback systems for distributor contracts
- Reporting revenue and cost data for financial analysis
- Conducting payer contract reviews for profitability
- Maximising reimbursement through coding accuracy
- Handling Medicaid rebate reporting requirements
- Managing Medicare Part B and D billing rules
- Tracking average sales price (ASP) and WAC fluctuations
- Analysing gross-to-net revenue gaps
- Using billing audits to catch underpayment patterns
- Training staff on compliance-conscious billing practices
Module 11: Data Management and Reporting - Designing patient databases with structured fields
- Protecting data integrity and preventing duplication
- Generating reports on therapy start rates and persistence
- Analysing denial and appeal success metrics
- Tracking patient outcomes against clinical goals
- Measuring time-to-fill and cycle time efficiency
- Creating dashboards for operational leadership
- Exporting data for accreditation documentation
- Integrating with EMR and EHR systems where applicable
- Using data to justify program expansion
- Monitoring adherence rates by drug class and payer
- Reporting on financial assistance utilisation
- Identifying trends in patient complaints or barriers
- Automating routine reporting cycles
- Ensuring compliance with data retention policies
Module 12: Accreditation and Quality Improvement - Preparing for URAC Specialty Pharmacy accreditation
- Meeting The Joint Commission outpatient pharmacy standards
- Documenting policies and procedures for audit review
- Conducting mock surveys and gap assessments
- Implementing continuous quality improvement (CQI) cycles
- Analysing root causes of operational failures
- Setting measurable quality goals and tracking progress
- Gathering patient satisfaction feedback systematically
- Training staff on accreditation expectations
- Developing emergency preparedness and business continuity plans
- Validating staff competency in specialty workflows
- Managing vendor credentialing and oversight
- Conducting annual risk assessments
- Submitting required reports to accrediting bodies
- Earning distinction through performance excellence
Module 13: Program Development and Expansion - Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Validating prescription accuracy before dispensing
- Temperature-sensitive packaging and cold chain logistics
- Shipping methods: overnight, white glove, and in-person delivery
- Signature requirements and adult confirmation protocols
- Tracking shipment status and delivery confirmation
- Handling delivery failures and redelivery scheduling
- Inventory management for high-cost, low-turnover medications
- Reconstituting and preparing injectable therapies safely
- Dosing accuracy checks and pharmacist verification steps
- Labelling requirements for specialty medications
- Developing emergency dispensing protocols
- Managing partial vial use and waste documentation
- Coordinating with home health nurses for administration support
- Handling patient self-administration training needs
- Creating pharmacist sign-off checklists for each shipment
Module 8: Patient Education and Adherence Support - Developing condition-specific patient education modules
- Teaching proper storage and handling of temperature-sensitive drugs
- Reviewing injection techniques and self-administration steps
- Recognising and managing common side effects
- Providing medication guides and illustrated instructions
- Scheduling structured touchpoints during treatment
- Using teach-back methods to confirm understanding
- Creating personalised adherence calendars
- Addressing fears or misconceptions about therapy risks
- Integrating mental health screening into adherence plans
- Identifying adherence barriers: cost, complexity, stigma
- Setting up reminder systems: SMS, phone, email
- Motivational interviewing techniques for resistant patients
- Documenting patient understanding in clinical records
- Transitioning patients to maintenance therapy phases
Module 9: Clinical Monitoring and Safety Surveillance - Designing lab monitoring schedules by therapy type
- Tracking adverse events and medication reactions
- Establishing escalation protocols for severe side effects
- Coordinating with prescribers for dose adjustments
- Managing drug-drug and drug-disease interactions
- Monitoring for immunogenicity and loss of response
- Tracking patient-reported outcomes and symptom changes
- Using standardised assessment tools (PROMs, PHQ-9, etc.)
- Scheduling routine clinical follow-ups at defined intervals
- Reporting to registries and post-marketing surveillance
- Documenting clinical interventions and outcomes
- Managing long-term safety for chronic therapies
- Identifying red flags that require immediate action
- Creating clinician handoff templates for care transitions
- Integrating pharmacist recommendations into treatment plans
Module 10: Reimbursement and Billing Operations - Understanding J-codes and HCPCS coding for injectables
- Billing under the pharmacy vs medical benefit
- Submitting claims with appropriate modifiers and line items
- Handling rejected claims and remittance advice review
- Calculating acquisition cost and reimbursement margins
- Managing chargeback systems for distributor contracts
- Reporting revenue and cost data for financial analysis
- Conducting payer contract reviews for profitability
- Maximising reimbursement through coding accuracy
- Handling Medicaid rebate reporting requirements
- Managing Medicare Part B and D billing rules
- Tracking average sales price (ASP) and WAC fluctuations
- Analysing gross-to-net revenue gaps
- Using billing audits to catch underpayment patterns
- Training staff on compliance-conscious billing practices
Module 11: Data Management and Reporting - Designing patient databases with structured fields
- Protecting data integrity and preventing duplication
- Generating reports on therapy start rates and persistence
- Analysing denial and appeal success metrics
- Tracking patient outcomes against clinical goals
- Measuring time-to-fill and cycle time efficiency
- Creating dashboards for operational leadership
- Exporting data for accreditation documentation
- Integrating with EMR and EHR systems where applicable
- Using data to justify program expansion
- Monitoring adherence rates by drug class and payer
- Reporting on financial assistance utilisation
- Identifying trends in patient complaints or barriers
- Automating routine reporting cycles
- Ensuring compliance with data retention policies
Module 12: Accreditation and Quality Improvement - Preparing for URAC Specialty Pharmacy accreditation
- Meeting The Joint Commission outpatient pharmacy standards
- Documenting policies and procedures for audit review
- Conducting mock surveys and gap assessments
- Implementing continuous quality improvement (CQI) cycles
- Analysing root causes of operational failures
- Setting measurable quality goals and tracking progress
- Gathering patient satisfaction feedback systematically
- Training staff on accreditation expectations
- Developing emergency preparedness and business continuity plans
- Validating staff competency in specialty workflows
- Managing vendor credentialing and oversight
- Conducting annual risk assessments
- Submitting required reports to accrediting bodies
- Earning distinction through performance excellence
Module 13: Program Development and Expansion - Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Designing lab monitoring schedules by therapy type
- Tracking adverse events and medication reactions
- Establishing escalation protocols for severe side effects
- Coordinating with prescribers for dose adjustments
- Managing drug-drug and drug-disease interactions
- Monitoring for immunogenicity and loss of response
- Tracking patient-reported outcomes and symptom changes
- Using standardised assessment tools (PROMs, PHQ-9, etc.)
- Scheduling routine clinical follow-ups at defined intervals
- Reporting to registries and post-marketing surveillance
- Documenting clinical interventions and outcomes
- Managing long-term safety for chronic therapies
- Identifying red flags that require immediate action
- Creating clinician handoff templates for care transitions
- Integrating pharmacist recommendations into treatment plans
Module 10: Reimbursement and Billing Operations - Understanding J-codes and HCPCS coding for injectables
- Billing under the pharmacy vs medical benefit
- Submitting claims with appropriate modifiers and line items
- Handling rejected claims and remittance advice review
- Calculating acquisition cost and reimbursement margins
- Managing chargeback systems for distributor contracts
- Reporting revenue and cost data for financial analysis
- Conducting payer contract reviews for profitability
- Maximising reimbursement through coding accuracy
- Handling Medicaid rebate reporting requirements
- Managing Medicare Part B and D billing rules
- Tracking average sales price (ASP) and WAC fluctuations
- Analysing gross-to-net revenue gaps
- Using billing audits to catch underpayment patterns
- Training staff on compliance-conscious billing practices
Module 11: Data Management and Reporting - Designing patient databases with structured fields
- Protecting data integrity and preventing duplication
- Generating reports on therapy start rates and persistence
- Analysing denial and appeal success metrics
- Tracking patient outcomes against clinical goals
- Measuring time-to-fill and cycle time efficiency
- Creating dashboards for operational leadership
- Exporting data for accreditation documentation
- Integrating with EMR and EHR systems where applicable
- Using data to justify program expansion
- Monitoring adherence rates by drug class and payer
- Reporting on financial assistance utilisation
- Identifying trends in patient complaints or barriers
- Automating routine reporting cycles
- Ensuring compliance with data retention policies
Module 12: Accreditation and Quality Improvement - Preparing for URAC Specialty Pharmacy accreditation
- Meeting The Joint Commission outpatient pharmacy standards
- Documenting policies and procedures for audit review
- Conducting mock surveys and gap assessments
- Implementing continuous quality improvement (CQI) cycles
- Analysing root causes of operational failures
- Setting measurable quality goals and tracking progress
- Gathering patient satisfaction feedback systematically
- Training staff on accreditation expectations
- Developing emergency preparedness and business continuity plans
- Validating staff competency in specialty workflows
- Managing vendor credentialing and oversight
- Conducting annual risk assessments
- Submitting required reports to accrediting bodies
- Earning distinction through performance excellence
Module 13: Program Development and Expansion - Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Designing patient databases with structured fields
- Protecting data integrity and preventing duplication
- Generating reports on therapy start rates and persistence
- Analysing denial and appeal success metrics
- Tracking patient outcomes against clinical goals
- Measuring time-to-fill and cycle time efficiency
- Creating dashboards for operational leadership
- Exporting data for accreditation documentation
- Integrating with EMR and EHR systems where applicable
- Using data to justify program expansion
- Monitoring adherence rates by drug class and payer
- Reporting on financial assistance utilisation
- Identifying trends in patient complaints or barriers
- Automating routine reporting cycles
- Ensuring compliance with data retention policies
Module 12: Accreditation and Quality Improvement - Preparing for URAC Specialty Pharmacy accreditation
- Meeting The Joint Commission outpatient pharmacy standards
- Documenting policies and procedures for audit review
- Conducting mock surveys and gap assessments
- Implementing continuous quality improvement (CQI) cycles
- Analysing root causes of operational failures
- Setting measurable quality goals and tracking progress
- Gathering patient satisfaction feedback systematically
- Training staff on accreditation expectations
- Developing emergency preparedness and business continuity plans
- Validating staff competency in specialty workflows
- Managing vendor credentialing and oversight
- Conducting annual risk assessments
- Submitting required reports to accrediting bodies
- Earning distinction through performance excellence
Module 13: Program Development and Expansion - Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Conducting a needs assessment for new therapies
- Developing a business case for specialty program launch
- Calculating startup costs and break-even projections
- Securing internal funding and stakeholder buy-in
- Designing service models: in-house, hybrid, or outsourced
- Hiring and training specialty pharmacy staff
- Establishing referral networks with prescribers
- Marketing services to patients and providers
- Integrating with population health initiatives
- Launching condition-specific programs (e.g., MS, RA, CF)
- Measuring return on investment (ROI) of new services
- Expanding into rare disease or gene therapy support
- Developing clinical pathways in collaboration with providers
- Creating standard operating procedures (SOPs)
- Scaling operations while maintaining quality
Module 14: Integration with Healthcare Ecosystems - Building relationships with oncology and specialty clinics
- Integrating with accountable care organisations (ACOs)
- Supporting transitions of care from hospital to home
- Participating in care coordination teams
- Sharing treatment updates with primary care providers
- Collaborating on medication therapy management (MTM)
- Supporting provider offices with hub-like services
- Participating in value-based contracts and risk sharing
- Contributing to formulary discussions and P&T committees
- Providing real-world evidence from patient outcomes
- Closing referral loops with automated notifications
- Using warm handoffs to improve patient retention
- Aligning with patient-centred medical homes
- Supporting telehealth and virtual care models
- Establishing feedback mechanisms with prescribers
Module 15: Career Advancement and Leadership - Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap
- Positioning your specialty pharmacy experience on your resume
- Preparing for interviews in health system or industry roles
- Networking with specialty pharmacy leaders and associations
- Pursuing additional certifications (BCSCP, CMC, etc.)
- Presenting outcomes data at conferences or internal meetings
- Leading quality improvement projects
- Mentoring junior staff and interns
- Developing speaking and presentation skills
- Writing protocols and clinical guidelines
- Becoming a preceptor for pharmacy students
- Advancing into director or consultant roles
- Contributing to clinical research and publications
- Leveraging your Certificate of Completion for promotions
- Building a personal brand in specialty pharmacy
- Creating a long-term professional development roadmap