Ambulatory Medication Access Coordinator

St. Mary's Hospital - Kankakee • Kankakee, IL

2d • $23 - $33

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. Responsibilities include referral review and processing, patient scheduling, maintaining accurate activity and outcome records, evaluating insurance coverage to support medication access, and helping implement and maintain medication access workflows across ambulatory pharmacy service departments. The coordinator 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, collaborates with referring providers to clarify information, and contacts and interviews patients to obtain additional information and coordinate scheduling as appropriate. They document activities in the electronic medical record and apply expertise in prior authorization management, insurance types, specialty medication access, financial assistance, and 340B program requirements. They also help patients access pharmaceutical foundation programs, manufacturer copay assistance, internal medication assistance, and charity options, including for uninsured and underinsured patients.

Depending on case acuity, the coordinator reviews cases with the Ambulatory Pharmacy Technician Supervisor or overseeing pharmacist to avoid gaps in care. Using independent judgment, the coordinator prioritizes work, manages patient problems, supports timely medication access, answers financial questions, documents authorization outcomes, and acts as a subject matter expert and operational resource for clinical leadership, providers, and prior authorization coordinators.

Requirements

• High school diploma or equivalent.
• Current State of Illinois pharmacy technician license in good standing.
• Certified Pharmacy Technician (CPhT) credential.
• Minimum of 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 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 ambulatory care referrals, assess whether referrals are appropriate, and seek clarification from referring providers when needed.
• Conduct patient outreach and interviews to collect information and coordinate scheduling as appropriate.
• Maintain accurate electronic medical record documentation of activities and outcomes.
• Evaluate patient insurance and manage prior authorizations to support medication access.
• Support specialty medication access and ensure prescriptions follow required steps to qualify for the 340B program.
• Assist patients with pharmaceutical foundation programs, manufacturer copay assistance cards, internal medication assistance processes, and other available charity options.
• Manage uninsured and underinsured patient referrals and support enrollment in patient assistance programs.
• Help implement medication access workflows in newly established ambulatory pharmacy departments and validate workflows at existing departments.
• Serve as a liaison among providers, pharmacies, insurance carriers, patients, and external offices.
• Answer financial questions from patients and providers and document authorization outcomes.
• Review cases with the Ambulatory Pharmacy Technician Supervisor or overseeing pharmacist, as appropriate, to avoid gaps in care.
• Prioritize workflow, manage patient problems, and support timely access to medications.
• Provide subject matter expertise and operational support to clinical leadership, providers, and prior authorization coordinators.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Paid time off
• 401(k) retirement plan
• Tuition reimbursement
• Continuing education opportunities
• Specialized training through the PrimE-Academy professional development platform
• Voluntary benefit options

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED