Specialty Quality Coordinator

Overview

Under the guidance of the Assistant Director of Pharmacy Outpatient Services, the Specialty Accreditation & Patient Advocate Technician is responsible to ensure the Pharmacy is complying with URAC and ACHC Accreditation standards.  This position will assist the Assistant Director of Pharmacy Outpatient Services in reporting on these standards and renewing accreditation upon renewal. The position will also be responsible to in assisting the Assistant Director of Pharmacy Outpatient Services in billing and all auditing records. Oversee all Medication Access Specialists in day-to-day tasks and ensure compliance with all policies and procedures. 

Responsibilities

Quality Management and AccreditationThis area involves supporting committee work by running reports, preparing scorecards, and documenting meeting notes for quarterly Quality Management Committee (QMC) and annual PAC meetings. The position provides annual reporting by compiling quality reports and QMC summaries to track performance trends. Additionally, it ensures all pharmacy policies and procedures are updated to maintain accreditation standards and oversees annual compliance requirements such as fire drills, hazard training, and business continuity testing.

Operational Auditing and ComplianceResponsibilities include completing daily insurance audits and assisting with annual 340B audits, specifically for contract pharmacy prescriptions. The role performs clinical verification by auditing patient assessments and temperature monitoring records for timely completion. Furthermore, the position manages communication and compliance logs, maintains current patient-facing materials, and tracks incident reports while ensuring HR has necessary audit documentation, including staff license verifications.

Team Leadership and SupervisionThe position manages day-to-day operations for Medication Access Specialists and Medication Assistant Coordinators within the Drug Recovery Program. This includes resolving scheduling conflicts and ensuring all team members complete yearly competency training. The role is also responsible for maintaining specific policies for the access and recovery teams to ensure strict adherence to retail financial assistance guidelines.

Revenue Cycle and Clinical SupportThe role monitors and ensures that all outstanding pharmacy claims are paid in a timely manner. It provides operational assistance to Pharmacists, Physicians, and Nurses regarding Celgene prescriptions and specialized medication access. Additionally, the position audits and verifies all records within the Drug Recovery Program to ensure ongoing program integrity and compliance.

Administrative and General SupportThis area includes the management of the pharmacy website and internal communication materials to ensure organizational charts and hazard protocols are up to date. The position also performs other duties as assigned by the Assistant Director of Outpatient Pharmacy Services to support overall departmental goals and operational efficiency.

 

 

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.

• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.

• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Qualifications

Registration: Active Alabama Pharmacy Technician registration by start date.

Certification: National PTCB or ExCPT certification required.

Education: High School diploma or equivalent required.  Bachelor’s degree preferred.

Required: 1+ years in medication reimbursement, insurance preauthorization, patient assistance programs, and URAC/ACHC accreditation standards.

Preferred: 3+ years of pharmacy practice experience.

Technical: Proficient in Microsoft Office, pharmacy equipment, and pharmacology (medication classes).

Professional: Strong interpersonal, telephone,