Medication Access Specialist
About The Position
The Medication Access Specialist supports centralized medication access services for patients receiving high-cost infusion and specialty therapies. As part of the Centralized Drug Channel & Specialty Access function within Pharmacy, the position evaluates medical and pharmacy benefit coverage, investigates payer requirements, coordinates prior authorization and access activities, and communicates benefit findings to support timely progression through the enterprise-approved drug channel pathway. The Specialist works collaboratively with the Medication Access Manager, Drug Channel Coordination, Specialty Pharmacy Access, Specialty Pharmacy Operations, Infusion Pharmacy, clinical teams, patient financial advocacy, payers, and pharmacy leadership to minimize treatment delays and support appropriate medication access and financial stewardship.
Requirements
- High school diploma or equivalent required.
- Working knowledge of medical and pharmacy benefit structures, prior authorization processes, payer policies, specialty pharmacy requirements, site-of-care restrictions, and high-cost medication access.
- Familiarity with drug channel concepts including medical versus pharmacy benefit, buy-and-bill, specialty pharmacy routing, payer-mandated specialty pharmacy, 340B, GPO, and limited-distribution requirements.
- Ability to distinguish benefit/access functions from pharmacist-required clinical, counseling, prescription verification, and dispensing responsibilities.
- Strong communication, organization, documentation, problem-solving, prioritization, attention to detail, and follow-through skills.
Nice To Haves
- Associate or bachelor's degree in healthcare, business, pharmacy, finance, or a related field preferred but not required.
- Minimum two years of experience in medication access, patient access, business office operations, medical or pharmacy benefits, prior authorization, reimbursement, specialty pharmacy, infusion services, or a related healthcare setting preferred.
- Experience evaluating medical and/or pharmacy benefits for high-cost medications preferred.
- Oncology, infusion, specialty pharmacy, reimbursement, or complex medication-access experience preferred.
- Pharmacy technician registration and/or Certified Pharmacy Technician (CPhT) certification preferred only when applicable to an individual's background or assigned responsibilities.
Responsibilities
- Benefit Investigation & Medication Access
- Prior Authorization & Payer Coordination
- Drug Channel & Specialty Access Support
- Patient / Care Team Communication & Handoffs
- Documentation, Quality & Compliance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
