Medication Access Coordinator

Responsibilities

• Completes prior authorization forms, negotiates authorization status with insurers, tracks prescription approval status, and alerts clinical pharmacists of denials or nonresponse.
• Facilitates enrollment of patients in patient assistance programs and collaborates with social services and case management.
• Affords assistance to pharmacists with preparing letters of medical necessity and coordinating peer-to-peer conferences.
• Expedites clinic workflow and enhances patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, and clinic staff.
• Communicates and collaborates regarding patient therapy interruptions, additional therapy monitoring requirements, and alternative care delivery setting options.
• Facilitates adherence to medications by ensuring patients receive prescribed medications in a timely manner and makes scheduled calls to obtain clinical information and process prescription refills.
• Documents and triages patient problems with therapy to the appropriate pharmacist, assures documentation of problem and follow-up, and assists with coordination of filling, packaging, and delivery of prescriptions.
• Observes and understands prescribing trends within ambulatory clinics to identify areas for improved specialty pharmacy contracting.
• Develops marketing materials and communication strategies under the guidance of the pharmacy management team to increase patient recruitment and prescription capture rate of high-cost take-home medications.
• Assists with the development and implementation of policies and procedures to ensure reimbursement of high-cost medications.
• Facilitates staff training and competency, education, and practice advancement, including training new staff members and coordinating with the manager to develop and maintain a training and competency program for specialty pharmacy technician staff.
• Improves patient service experience and maximizes pharmacy revenue through provision of prior authorization services for high-cost medications.
• Conducts patient insurance, benefits, and financial investigation and verification by directly communicating with patients.

Requirements

• Experience with pharmacy benefits plans and secondary insurance providers (copay assistance).
• Accuracy and attention to detail for long periods of time; excellent organization skills.
• Ability to interpret prescription and knowledge of the generic names of medications and medical terminology; vast understanding of mathematical principles to perform pharmaceutical calculations.
• Ability to critically think through situations with good problem-solving skills.
• Good customer service skills and values teamwork.
• Must be able to multitask and be flexible in moving from task to task within the department while maintaining composure and staying organized.
• Basic to moderate proficiency skill set in MS Office: Word, Excel and Outlook.

Qualifications

• High School Grad or Equiv
• Field Of Study N/A
• Work Experience 1+ years retail, specialty, or mail-order pharmacy setting
• 5+ years of ambulatory or specialty pharmacy experience
• Pharmacy Benefit Management (PBM), managed healthcare organization, insurance experience

Skills

• Accuracy and attention to detail
• Attention to detail
• Attention to detail for long periods of time
• Customer service skills
• Flexibility
• Good problem-solving skills
• Good teamwork
• Interpretation of prescription
• Knowledge of medical terminology
• Knowledge of the generic names of medications
• Mathematical principles
• Multi-tasking
• Organization skills
• Patient service experience
• Problem-solving skills
• Teamwork
• Time management
• Understanding of mathematical principles
• Understanding of medical terminology
• Understanding of the generic names of medications
• Understanding of prescribing trends
• Understanding of work requirements
• Work experience
• Workplace flexibility

Benefits

• Medical, Dental, Vision Insurance
• Life Insurance
• Disability Insurance
• Paid Time Off
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule

• Full time
• Day

Pay

• $22.68 - $42.19