Pharmacy Medication Coordinator

3 weeks ago

Denver, Colorado, United States Denver Health Full time

Job Summary

We are seeking a highly skilled Medication Assistance Coordinator, Pharmacy Technician to join our team at Denver Health. This role is responsible for providing access to medications for patients by completing prior authorization requests, co-pay assistance programs, medication assistance programs, benefits investigation, coordinating refill renewal requests, and assisting patients without health insurance to connect with the Enrollment department as applicable.

Clinical and technical knowledge is utilized to operate web-based applications, work in Microsoft Word and Excel, and analyze and audit pharmacy usage reports.

Essential Functions:

  • Serve as a referral point and as the expert in submitting applications for patients to receive provided drug and co-pay assistance from pharmaceutical manufacturer assistance programs.
  • Coordinate applications for assistance meeting drug-specific requirements for participation, including but not limited to forms, patient proof of income, relative clinical information, and physician or provider signature.
  • Track each request to achieve timely approval & follow-up with appropriate individuals when not approved.
  • Displays effective file management by maintaining documentation and detailed records of program participation, medications dispensed, and value of medications provided to patients via the Medication Assistance Program.
  • Completes consistent documentation in the electronic health record per program standard of practice.
  • Effective analysis and use of management data and reports to establish standards to monitor and improve contract performance.
  • Works with the Enrollment Services Department to directly enroll eligible patients into manufacturer patient assistance and co-pay programs.
  • Collaborate with other departments providing pharmacy related information to nurse case managers, complex case workers, health coaches, and patient navigators.
  • Work cooperatively with other staff members and clinic staff.

Requirements:

  • High School Diploma or GED Required
  • 1-3 years of pharmacy technician experience or equivalent experience performing prior authorizations Required
  • PHAT-Licensed Pharmacy Technician - DORA - Department of Regulatory Agencies Required
  • CPHT-Certified Pharmacy Technician - PTCB - Pharmacy Technician Certification Board Required

Knowledge, Skills and Abilities:

  • Extensive knowledge of health care administration, including Medicare, managed care, Medicaid and CHP+ eligibility and enrollment processes
  • Extensive knowledge of eligibility determination systems
  • Knowledge of federal and Colorado statutes, legislative initiatives and regulations, as well as federal, State and local policies
  • Excellent communication and organizational skills
  • Analytical thinking, problem solving, and process improvement skills
  • Ability to work independently and with little supervision
  • Ability to disseminate program information, policies, rules and/or regulations
  • Ability to simultaneously coordinate and manage several functions, programs, and projects in various stages of completion
  • Ability to consistently implement program, department and organizational policies and procedures
  • Demonstrates exceptional interpersonal and customer service skills in all interactions with internal and external healthcare team members
  • Demonstrates exceptional interpersonal and customer service skills in all interactions with patients
  • Understands how state and federal laws, regulations, policies and procedures impact specific job responsibilities and functions
  • Demonstrates actions to reasonably prevent, detect, and report unethical and unlawful business practices
  • Proficiency with Microsoft Office required
  • Proficiency with Epic, preferred

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