Medication Access Specialist

3 days ago

Atlanta GA United States Emory Healthcare Full time
Overview:

Belong. Connect. Thrive. At Emory Healthcare our team is leading the way in shaping the future of health care. We unite to improve lives through innovation, compassion, and unwavering commitment to achieving unparalleled excellence in patient care. Our pharmacy staff works side by side with our fellow health care providers creating an interdisciplinary team approach to patient care. The Pharmacy at Emory’s goal is to provide patient- and-family centered medication management to the patients we serve. We’re defining a new standard of care for humankind.

Description:

The Medication Access Specialist is a dedicated member of the Emory Healthcare Pharmacy Department whose primary responsibility will be navigating patients who are prescribed specialty medications through the intricacies of their insurance benefits in order to maximize medication access and minimize financial burden.

Shift Time: 8a-5p

The individual acts on behalf of the clinic team, as the liaison between patient, pharmacy, insurance providers, and other third parties to improve patient time to treatment on specialty medications, improve patient satisfaction, and increase profitability to Emory Healthcare.
The individual is responsible for obtaining medication insurance coverage and benefit information, authorizations of medications, monitoring of patient insurance status, and communication of medication access issues to the treatment team for all specialty medications within their scope of practice.
Obtain detailed insurance benefit information including but not limited to; appropriate billing information (medical vs prescription benefits), copays, in-network pharmacies, plan formulary, prior authorization requirements, and other necessary information to successfully adjudicate a specialty medication claim.
Interacts with patients, physicians, caregivers, team members (pharmacists, pharmacy, nurse, provider), and other internal/external stakeholders in a courteous and professional manner.

Minimum Qualifications:

High school diploma or equivalent.
5 years' experience in retail pharmacy, healthcare, managed care or health insurance environmental required.
Knowledge of health insurance and pharmacy insurance benefits verification, health insurance terminology, billing, managed care contracting, hospital reimbursement required.
Strong technical writing and presentation skills required.
Strong analytical skills with the ability to collect, analyze and disseminate information.
Excellent customer service experience required.
Must have and maintain national CPhT certification.
Active Pharmacy Technician license in the state of Georgia required.

JOIN OUR TEAM TODAY Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet® designated ambulatory practice. We are made up of 11 hospitals-4 Magnet® designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.

Additional Details:
Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

ACCOMODATIONS: EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”

PHYSICAL REQUIREMENTS: (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.

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