Ambulatory Pharmacy Coordinator

Job Description:

The Ambulatory Pharmacy Coordinator is accountable for medication access. This position involves oversight of prior authorization requests, copay assistance, and manufacturer-provided free drug applications. The incumbent communicates and coordinates information related to medication access to the clinical staff and other appropriate key stakeholders, as well as the patient.

This position will work Monday – Friday clinic hours are generally 8-530 (Monday- Thursday); 8-1230 (Friday).

Scope

ESSENTIAL DUTIES
1. Assists with all phases of pharmacy services. Works with patients, providers, and insurance AND companies to obtain prior authorizations. Answers phones and notes from physicians in a timelymanner. Accurately reads, interprets and enters prescriptions in a timely manner. Routes questionable prescriptions to the pharmacist for completion. Communicates with physicians and clinic staff for prescription clarification, substitutions and formulary changes as needed.
2. Assists pharmacist by gathering clinical information on patients. Assists the Clinical Pharmacy Specialist in providing pharmacy services to the patients of the assigned clinic, including: finding funding assistance for patient copays, assists patients with completing required registration forms for pharmaceutical programs, reimbursement applications, and other forms as needed for their pharmaceutical care, and represents the pharmacy to the providers and provider clinic staff when the Clinical Pharmacy Specialist is unavailable.
3. Meets with patients to review and process financial assistance applications. Ensures completeness, verifies supporting documentation, and manages the eligibility determination process.
4. Routes prescriptions to the appropriate pharmacy for filling, emphasizing the clinical and patient service advantages of using SCL Health Pharmacy Services as the filling pharmacy.
5. If appropriate, connect patient with medication adherance and synchronization programs to maximize the patients benefit derived from SCL Health Pharmacy Services.
6. Assists patients in reviewing their current pharmacy benefits, and assists patients with open enrollment and future pharmacy benefit selection, based on their pharmaceutical needs.
7. Provides patients with price quotes, coinsurance/cost sharing estimates, and coordinates payment for services with the dispensing pharmacy.
8. Provides patients with a clear explanantion of their pharmacy benefit, including reasoning behind coinsurance/cost-sharing. Answers questions related to coverage and billing.
9. Provides pharmacy support to patients who are forced to use external pharmacies for their care, including helping patients troubleshoot issues with getting their prescriptions filled.
10. Communicates benefit decision to physicians, physician's office staff, medical management staff and/or pharmacists.
11. Researches, resolves and documents prior authorization outcomes in pharmacy system. Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician's office staff, medical management staff and/or pharmacists. Escalates requests to pharmacist when request requires extensive clinical review or denial. Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
12. Participates in quality and patient safety initiatives. Identifies potential areas for improvement including processes that could be streamlined or revised to improve patient satisfaction. Identifies potential safety hazards that may create problems for patients and/or staff, and takes appropriate actions. Maintains cleanliness of all assigned clinic working areas. Participates in departmental meetings, contributing ideas or feedback.
13. Completes documentation according to departmental standards and navigates multiple pharmacy and EHR software programs.
14. Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
15. Performs other duties as assigned.
16. May be required to float to other departments (within scope of competency and qualifications) based on business need.

Minimum Qualifications:

• High School Diploma or equivalent
• Pharmacy Technician certification (CPhT) or certified within 90 days of hire Certified Pharmacy Technician in state of practice by March 2020
• or
• Licensed Pharmacy Technician in state of practice CAC/CAAS Certification, or newly certified at next training opportunity
• Two (2) years working as a certified pharmacy tech in a retail pharmacy setting

Preferred Qualifications:

• Completion of technician-training program
• One (1) year