Pharmacy Access Rep III – Specialty Pharmacy

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

500160 Pharmacy SMH

Work Shift:

UR - Day (United States of America)

Range:

UR URCA 206 H

Compensation Range:

$19.08 - $25.77

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

GENERAL PURPOSE:
The Pharmacy Access Representative III (PAR) is responsible for the overall management of medication coordination and removal of barriers that prevent patients from receiving their medications. Duties will include communication with the prescriber’s office to acquire necessary information to submit prescriptions to the patient’s insurance for approval including prior authorization and helping enroll patients in financial assistance programs and arrange timely delivery of the medication. The PAR will link communication between the patient, pharmacist, insurance, and staff to ensure coordinated care.

The PAR will be assigned a set of patients to manage along with a pharmacist. Daily tasks are completed independently and prioritized based on the patient and pharmacist needs. Duties of this position require proper judgement, sensitivity, and strict adherence to Strong Memorial Hospital policy on confidentiality and the protection of Private Health Information. The PAR interacts with multiple individuals within the institution including, but not limited to, hospital and clinical employees at various levels including pharmacists, pharmacy technicians, medical/clinical staff, and central prior authorization staff. External interactions include third party payors, governmental peer review organizations, and referring physicians. To be successful, this individual must have excellent phone etiquette and be open to feedback to create strong collaborative work relationships.

ESSENTIAL FUNCTIONS:

Pharmacy Coordination

• Coordinates medication and supplies preparation with pharmacy staff to ensure timely delivery. Troubleshoots insurance issues with pharmacists, physicians, and staff to prevent treatment interruptions.
• Follow-up with patients to ensure safe and effective medication use. Documents problems with the medication (i.e. delivery issues, side effects, adherence, difficulty with administration, etc.) and triages issues to the pharmacist when appropriate.
• Coordinates medication ordering with inventory manager for special order or low volume medications. Tracks changes in prescribing trends and coordinate with inventory manager if changes in stock on hand is needed.
• Makes scheduled calls to patient to bill prescriptions and set up deliveries. Facilitates adherence to medications by ensuring that patients receive prescribed medications in a timely manner.
• Provides excellent customer service through the Pharmacy Call Center. Triages patient calls to appropriate party. Answer incoming calls in a timely manner. 
• Monitors and reconciles patient charge accounts once a month.

Financial Assistance Management

• Maintains expertise on all potential patient assistance programs (PAP), grants, foundations, and coupons relevant to the high-cost drugs prescribed in their assigned area(s).
• Analyzes patients that are receiving high-cost medications for potential participation in PAPs, and identifies the best option(s) for the patient given their overall circumstances (insurance, disease state, income, etc).  Coordinates with the patient and/or family to obtain necessary information including income information and other personal details, as well as to present PAP options to the patient/family when there are multiple options.
• Enrolls patients in PAPs using the needed permission and information, follow-up to determine the status of the application, and ensure proper documentation of this process. Submits all required documentation to the PAP throughout the duration of treatment to verify payment for ea