Medication Access Coordinator

Trinity Health•Waterloo, IA

1d•Onsite

About The Position

Provides integrated support to patients, pharmacists, and other clinicians by facilitating our medication adherence and prescription assistance programs and is related to the growth and maintenance of Pharmacy business operations. Works closely with patients, clinicians, and our specialty pharmacy business line to deliver a full continuum of medication adherence support utilizing various tools and applications. Responsible for performing assigned tasks that require ability for independent judgment and increased competency skills relating to patient medication therapy. As a key individual providing pharmacy services, responsible for liaising between patients, pharmacies, payers, and providers with high accountability for follow through and task management. ESSENTIAL FUNCTIONS Understands and maintains confidentiality with respect to patient/client care by complying with all applicable federal and state laws, HIPAA, HITECH, and MercyOne policies related to protected health information (PHI) and electronic PHI (ePHI) in all tasks, whether in a pharmacy department or clinic setting. Review payer reports and determine appropriate course of action for management Participates in performance improvement (PI) activities as directed, including reporting variances, contributing to corrective action development, and supporting audits, whether working in a pharmacy department or clinic setting The role includes identifying opportunities for improvement, implementing solutions, and documenting results, ensuring that pharmacy services continually meet accreditation standards and regulatory requirement Determine daily task priorities based on business need Is flexible and able to adapt to changes, resolve unexpected problems, and handle different tasks and responsibilities without compromising the quality of work Triage patients need and assign to appropriate staff Organize work according to patient/customer needs Communicate with external entities as needed Perform all insurance benefit investigation, review claim rejects, overrides, etc. Work with patients to find financial aid (grants, manufacturing programs, discount cards etc.) to ensure they have access to the medications they need Provide direct support to patients to ensure that they are supported through their therapy regimen and achieve their intended outcome Ability to prioritize patient needs Serve as a liaison between clinicians, care coordinators, pharmacy, and assistance programs to ensure patient support throughout care Independently identify and/or manage designated tasks and prioritize work Create and/or maintain detailed resources and documents related to business operations and workflow Coordinate patient care activities and scheduling Use independent judgment and provide recommendations to care team members and clinicians as appropriate Access, input, and retrieve information through the Electronic Medical Record and Care Management computer network to maintain accurate records Participate in scheduled department meetings Comply with established procedures, rules, and regulations Conduct outreach calls to patient and pharmacy staff Handle patient issues in a calm manner and referring them to the pharmacist accordingly and notify the pharmacist of any issues Promote teamwork, professional services, and clear communication Recognize and adhere to the scope / limitations of job requirements Completes initial and ongoing competency assessments during orientation and annually thereafter, in accordance with MercyOne policies and accreditation standards Participates in performance improvement (PI) activities as directed, including reporting variances, contributing to corrective action development, and supporting audits, whether working in a pharmacy department or clinic setting. The Medication Access Coordinator works under the direct supervision of licensed pharmacists when in the pharmacy setting and under the direct supervision of licensed healthcare professionals in the clinic setting. All tasks are delegated in compliance with state regulations and organizational policies. Perform other related duties as assigned Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Mission Statement: We, MercyOne Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. Core Values: Reverence: We honor the sacredness and dignity of every person. Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable. Safety: We embrace a culture that prevents harm and nurtures a healing, safe environment for all. Justice: We foster right relationships to promote the common good, including sustainability of Earth. Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care. Integrity: We are faithful to those we say we are.

Requirements

High School diploma or GED required
Must be at least 18 years of age
At least three years of experience in pharmacy-related tasks, including health benefit investigations, prior authorization support, patient financial assistance, medical terminology, diagnoses, and procedures.
CPhT (Certified Pharmacy Technician), MA (Medical Assistant), or LPN (Licensed Practical Nurse) certification preferred.
For roles in the pharmacy department, candidates must have a Certified Pharmacy Technician (CPhT) license or be licensed as a Pharmacy Technician Trainee with certification required within the state’s legally mandated timeframes.
Proficiency in Microsoft Office products
Knowledge of Electronic Medical Records systems highly preferred
Ability to work across business lines effectively and communicate clearly with colleagues and patients/customers
Knowledge of health care payers and specialty pharmacy operations highly preferred
Completion of Mandatory Reporter training within 3 months of hire, with competency assessments in patient care, confidentiality, and regulatory compliance completed annually
Must be able to pass a pre-employment drug screening test at time of hire
Work onsite with regular and predictable attendance
Maneuver within the physical work environment with some bending, stooping, reaching, and light lifting
Constantly able to use hands and fingers to type, write, and file.
Frequently able to use near vision for viewing computer monitor and written materials.
Occasionally required to detect unusual odors that could indicate environmental issues
Ability to travel to assigned regions, other MercyOne or community facilities.
May drive a MercyOne vehicle, rental or own vehicle
Use of usual and customary equipment used to perform essential functions of the position
Must possess the ability to comply with Trinity Health policies and procedures.

Nice To Haves

CPhT (Certified Pharmacy Technician), MA (Medical Assistant), or LPN (Licensed Practical Nurse) certification preferred.
Knowledge of Electronic Medical Records systems highly preferred
Knowledge of health care payers and specialty pharmacy operations highly preferred

Responsibilities

Understands and maintains confidentiality with respect to patient/client care by complying with all applicable federal and state laws, HIPAA, HITECH, and MercyOne policies related to protected health information (PHI) and electronic PHI (ePHI) in all tasks, whether in a pharmacy department or clinic setting.
Review payer reports and determine appropriate course of action for management
Participates in performance improvement (PI) activities as directed, including reporting variances, contributing to corrective action development, and supporting audits, whether working in a pharmacy department or clinic setting
The role includes identifying opportunities for improvement, implementing solutions, and documenting results, ensuring that pharmacy services continually meet accreditation standards and regulatory requirement
Determine daily task priorities based on business need
Is flexible and able to adapt to changes, resolve unexpected problems, and handle different tasks and responsibilities without compromising the quality of work
Triage patients need and assign to appropriate staff
Organize work according to patient/customer needs
Communicate with external entities as needed
Perform all insurance benefit investigation, review claim rejects, overrides, etc.
Work with patients to find financial aid (grants, manufacturing programs, discount cards etc.) to ensure they have access to the medications they need
Provide direct support to patients to ensure that they are supported through their therapy regimen and achieve their intended outcome
Ability to prioritize patient needs
Serve as a liaison between clinicians, care coordinators, pharmacy, and assistance programs to ensure patient support throughout care
Independently identify and/or manage designated tasks and prioritize work
Create and/or maintain detailed resources and documents related to business operations and workflow
Coordinate patient care activities and scheduling
Use independent judgment and provide recommendations to care team members and clinicians as appropriate
Access, input, and retrieve information through the Electronic Medical Record and Care Management computer network to maintain accurate records
Participate in scheduled department meetings
Comply with established procedures, rules, and regulations
Conduct outreach calls to patient and pharmacy staff
Handle patient issues in a calm manner and referring them to the pharmacist accordingly and notify the pharmacist of any issues
Promote teamwork, professional services, and clear communication
Recognize and adhere to the scope / limitations of job requirements
Completes initial and ongoing competency assessments during orientation and annually thereafter, in accordance with MercyOne policies and accreditation standards
Participates in performance improvement (PI) activities as directed, including reporting variances, contributing to corrective action development, and supporting audits, whether working in a pharmacy department or clinic setting.
The Medication Access Coordinator works under the direct supervision of licensed pharmacists when in the pharmacy setting and under the direct supervision of licensed healthcare professionals in the clinic setting. All tasks are delegated in compliance with state regulations and organizational policies.
Perform other related duties as assigned
Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.