Medication Access Coordinator MercyOne Waterloo Pharmacy

Trinity Health•Waterloo, IA

About The Position

Position summary: 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. Shift: Days, 8-hour shifts What you will do: 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 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 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 Serve as a liaison between clinicians, care coordinators, pharmacy, and assistance programs to ensure patient support throughout care

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.
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.

Nice To Haves

CPhT (Certified Pharmacy Technician), MA (Medical Assistant), or LPN (Licensed Practical Nurse) certification 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
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
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
Serve as a liaison between clinicians, care coordinators, pharmacy, and assistance programs to ensure patient support throughout care