Pharmacy Medication Access Specialist, MAC - Cardiology Service Line

Job Summary: Activities to support the Medication Access Center (MAC). The MAC will serve as the hub for medication prior authorizations associated with key service lines within the medical center as well as several primary care clinics across various campuses. Medication Access Specialists are responsible for providing front line, direct contact with members, pharmacies and providers. They are responsible for supporting the prior authorization process with a full understanding of procedures related to verbal and electronic prior authorizations and can apply new processes and changes to existing PA processes. Medication Access Specialists will complete the medication prior authorizations for specific medications utilizing either pharmacy or medical benefits. This role will also have a key component in assisting with financial assistance for medication access as needed.  Medication Access Specialists must have strong customer service, communication, computer, and data entry skills. Attends periodic area meetings.  Attends required in-services and skills development courses and maintains technician certification.  This individual, like all department employees, will be expected to uphold the hospital’s key values and to be a team player at all times.

Primarily responsible for assisting with all aspects of medication access, including but not limited to collaboration with healthcare teammates, communication with patients, addressing and resolving medication-related needs, completing necessary reporting and/or auditing, and conducting and completing necessary third party (insurance) requests, as applicable. 

Position Highlights:

• Full-Time, Days
• 1st shift (0800-1900, hrs. vary based on clinic needs), M-F, weekend/holidays TBD
• Winston Campus
• $6,000 sign-on bonus eligible position for qualified candidates!   Click here for more information!

What We Offer:

• Day 1 Health Coverage: Choose from either copay or HSA-eligible health insurance options with coverage starting on your first day of work.   
• Generous PTO: Accrual starts at 25 days/year, to be used for vacations, sickness, holidays, and personal matters. 
• Education: Eligible for our Prepaid College Tuition Assistance program (up to $5,250/year)!
• Wellness Incentives: Up to $1,350/year in wellness incentives through our LiveWELL program.
• Parental Benefits: Six weeks paid birthing-mother maternity leave & four weeks paid parental leave for non-birthing parents. 
• Retirement: Up to 7% employer-paid retirement contributions.

How You’ll Impact Patient Care:

Your responsibilities may include, but are not limited to:

• Navigates various options for receiving prior authorization requests and further utilizing systems to find resources that best fit the patient’s needs, as applicable.
• Provides assistance to a subset of patients by completing Patient Assistance Program (PAP) applications and co-pay assistance applications.
• Assists patients by explaining the medication access process, which may include completing applications and reviewing documents required to complete the application.
• In collaboration with pharmacists, completes medication reconciliation, reviews prescription claim history for medication adherence and documents findings in the electronic health record, as applicable. Also available to patients and families to triage questions regarding medication access needs. 
• Verifies patient insurance benefits to minimize patient cost.
• Completes PAP and copay assistance applications, records qualitative monthly/quarterly feedback, refill reminders and medication shipment scheduling, and patient re-enrollment in appropriate assistance programs, as appropriate.
• Apply co-pay assistance payments to the appropriate patient account, as applicable. 
• Performs data entry and prepares tracking reports for both internal and external stakeholders.
• Garners and maintains knowledge of Health Plan compliance requirements, healthcare operations, and medical terminology.
• Efficiently determines a patient's ability to utilize enterprise pharmacy services.  Routes prescriptions to appropriate pharmacy, as necessary.
• Supports the development of methods of communication and coordination with patient care team to ensure timely and accurate fulfillment of orders for patient requests and clients.<