Medication Access Coordinator MTM

2 weeks ago

Hinsdale, Illinois, United States AdventHealth Full time

All the benefits and perks you need for you and your family:

·    Benefits from Day One for FT/PT positions

·    Paid Days Off from Day One for FT/PT positions

·    Student Loan Repayment Program for FT/PT positions

·    Career Development

·    Whole Person Wellbeing Resources

·    Mental Health Resources and Support

·    Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)

Our promise to you:

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time, 40 hours

Shift:   Monday-Friday 8 am – 4:30 pm

Location: AdventHealth Hinsdale Endocrinology Clinic - 911 N Elm Street

The role you'll contribute:

The Medication Access Coordinator is responsible for completing necessary functions to ensure optimal reimbursement for high cost, take home medications for patients receiving care in ambulatory clinics. Duties and responsibilities include: assistance with conducting and completing necessary third party prior authorization requests and associated services related to high cost medications, maximizing efficiency for patients and clinic staff.

The UChicago Advent Health Specialty Pharmacy services our Advent Health specialists who prescribe specialty medications for their patients. Our specialty pharmacy team receives the prescription at the pharmacy and the med access coordinator completes a benefit investigation/prior authorization, obtains financial assistance if necessary, and coordinates with our in-house specialty pharmacy or outside specialty pharmacies regarding delivery of the medication. The med access coordinator also serves as a liaison between the pharmacy and clinic to relay any medication delays/issues.

The value you'll bring to the team:

·       Report any misconduct, suspicious or unethical activities to the Director, Retail/Specialty, and Ambulatory Pharmacy Services.

·       Represent the pharmacy in a professional and courteous manner in all interactions with patients.

·       Improve patient service experience and maximize pharmacy revenue through provision of prior authorization services on behalf of clinics for select high-cost medications.

· Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete prior authorization forms, negotiate authorization status with insurers, track status of prescription approval, and when necessary, alert clinical pharmacists of denials or nonresponse.

·    Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance. Assist pharmacists with preparing letters of medical necessity and coordinating peer-to-peer conferences.

· Expedite clinic workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, and clinic staff. Communicate and collaborate regarding patient therapy interruptions, additional therapy monitoring requirements, and alternative care delivery setting options.

·    Communicates effectively with other members of healthcare team to provide appropriate escalation and handoffs with complex patient questions.

·     Facilitate adherence to medications by ensuring that patients receive prescribed medications in a timely manner. Make scheduled calls to patient to obtain clinical information regarding patient's experience with therapy and to process prescription refills. Document and triage patient problems with therapy to the appropriate pharmacist; assure documentation of problem and follow-up with patient and assist with coordination of filling, packaging and delivery of prescriptions. Coordinate synchronization of patients' prescriptions.

·      Coordinate with Manager to develop and maintain a training and competency program for specialty pharmacy technician staff that meets accreditation standards

·       Represent the department at hospital meetings, committees, and events as requested

·       Perform other duties as assigned by the pharmacist.

·       Works within mandated registered pharmacy technician scope of practice guidelines.

·       Ensure compliance with all licensure and federal, state, and local laws and regulations; observe the pharmacy's policies on "best practices".

·       Assist in resolving patient concerns and complaints.

·       Report product incidents as required in accordance with pharmacy policy.

·       Participate in surveys conducted by authorized inspection agencies.

·       Participate in the pharmacy's Performance Improvement program as requested by the Manager, Specialty and Ambulatory Pharmacy Services.

·       Participate in pharmacy committees when requested.

·       Participate in training/ education programs provided by the pharmacy.

·       Pursue continuing education programs appropriate to job responsibilities and certification requirements.

· Performotherdutiesasassignedby thepharmacist.

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