Ambulatory Medication Access and Referral Coordinator- Specialty Pharmacy

Saint Francis Hospital•Rich Township, IL

12d•$23 - $33•Hybrid

About The Position

The Ambulatory Medication Access and Referral Coordinator provides expert-level support to the Prime Healthcare Ambulatory Services Team across complex ambulatory pharmacy workflows. These include referral review and processing, patient scheduling, accurate activity and outcome records, and insurance evaluation to support medication access. The coordinator helps implement medication access workflows in newly established ambulatory pharmacy service departments and validates workflow maintenance in existing departments. The position serves as a liaison among providers, pharmacies, insurance carriers, and patients to streamline medication access, reduce financial barriers, and support continuity of care. The coordinator independently evaluates referrals for appropriateness, seeks clarifications from referring providers, and conducts patient outreach and interviews to gather information and arrange scheduling as appropriate. All activities are documented in the electronic medical record (EMR). The coordinator applies expertise in prior authorization management across insurance types, specialty medication access, financial assistance, and 340B program requirements. The role includes helping ensure prescriptions complete the steps needed to qualify for the 340B program and supporting patients with pharmaceutical foundation programs, manufacturer copay assistance cards, and internal medication assistance processes. Depending on case acuity, the coordinator reviews cases with the Ambulatory Pharmacy Technician Supervisor or overseeing pharmacist to help avoid gaps in care. Using independent judgment, the coordinator prioritizes workflow, manages patient issues, supports timely medication access, handles insurance authorization, answers financial questions, and documents authorization outcomes. The coordinator also manages referrals for uninsured and underinsured patients to support enrollment in available patient assistance and charity options, and serves as a subject matter expert and operational resource to clinical leadership, providers, and prior authorization coordinators.

Requirements

High school diploma or equivalent.
Current Illinois pharmacy technician license in good standing.
Certified Pharmacy Technician (CPhT) credential.
At least 3 years of experience in ambulatory care, specialty pharmacy, or 340B settings.
Proficiency with electronic medical record (EMR) systems and insurance authorization platforms.
Knowledge of HIPAA regulations and patient confidentiality standards.

Nice To Haves

Working knowledge of pharmaceutical foundation assistance programs and manufacturer copay card enrollment processes.
Experience qualifying and processing patients under 340B drug pricing program guidelines.
Strong understanding of commercial, Medicare, and Medicaid insurance plans and formulary requirements.
Experience coordinating patient outreach and scheduling in a high-volume clinical setting.
Excellent communication skills and ability to collaborate effectively with providers, pharmacies, payers, patients, and external offices.
Strong organizational skills and ability to manage multiple cases and meet deadlines in a fast-paced environment.

Responsibilities

Review and process referrals, determine appropriateness, obtain clarifications from referring providers, and conduct patient outreach and interviews as appropriate.
Schedule patients and maintain accurate records of activities and outcomes in the EMR.
Evaluate patients’ insurance and manage prior authorizations to support medication access.
Help implement medication access workflows in new ambulatory pharmacy departments and validate maintenance of workflows in existing departments.
Coordinate medication access among providers, pharmacies, insurance carriers, and patients to reduce financial barriers and support continuity of care.
Apply 340B program requirements and ensure prescriptions complete necessary steps to qualify for the program.
Coordinate financial assistance, including pharmaceutical foundation programs, manufacturer copay assistance cards, internal assistance processes, and available charity options.
Review cases with the Ambulatory Pharmacy Technician Supervisor or overseeing pharmacist when appropriate to help avoid gaps in care.
Prioritize workflow independently, manage patient problems, answer financial questions, and document authorization outcomes.
Manage referrals for uninsured and underinsured patients to support enrollment in patient assistance programs.
Serve as a subject matter expert and operational resource to clinical leadership, providers, and prior authorization coordinators.