Specialty Access & Assistance Coordinator

DCH Health System•Tuscaloosa, AL

8d•Onsite

About The Position

The Specialty Pharmacy Access & Assistance Coordinator is responsible for specialty medication access, dispensing, and patient financial navigation. Reporting to the Assistant Director of Pharmacy Outpatient Services, the Coordinator combines medication access and prior authorization work with patient assistance program and drug recovery functions. The role reviews patient drug benefits, pursues manufacturer and foundation funding for eligible patients, manages specialty medication orders and shipments, and maintains documentation supporting URAC and ACHC accreditation. The Coordinator works with pharmacists, providers, payers, and patients to help ensure timely and affordable access to specialty medications. The position also supports 340B compliance, insurance audits, claims monitoring, medication inventory, and pharmacy operational goals. Physical presence onsite is essential. The role involves exposure to contaminants, hazardous conditions, disease, infection, and hazardous materials; close physical proximity; and use of common protective or safety equipment. Work includes frequent telephone use, electronic communications, face-to-face discussions, and collaboration with others. Physical activity may include walking, bending, reaching, lifting, standing, and repetitive hand use, with light exertion requirements of up to 20 pounds occasionally and up to 10 pounds frequently. Prolonged sitting and/or standing may be required.

Requirements

Active Alabama Pharmacy Technician registration required by the start date.
National certification by PTCB or ExCPT required.
At least two years of combined experience in medication reimbursement, health care insurance prior authorization, and/or patient assistance program coordination.
Proficiency in Microsoft Office, pharmacy dispensing systems, and third-party reimbursement/PAP software platforms.
Strong communication and interpersonal skills, including telephone presence and etiquette.
Detail-oriented, with strong follow-up skills and ability to work under pressure and meet deadlines.
Better-than-average working knowledge of medications and medication classes.
Ability to read, write legibly, speak, and comprehend English.
Ability to perform the duties with or without reasonable accommodation.
Ability to tolerate prolonged periods of sitting and/or standing; hearing and vision must be normal or corrected to within normal range.
Must be reliable, responsible, dependable, careful with details, cooperative, ethical, and able to handle criticism and high-stress situations calmly.
Must be able to file and maintain records.
Physical presence onsite is essential.

Nice To Haves

Three or more years of pharmacy practice experience.
Experience with specialty pharmacy dispensing and drug recovery/patient assistance programs.
Baccalaureate degree strongly preferred.

Responsibilities

Review and verify patients’ drug benefit information in the electronic medical record and pharmacy computer system.
Submit third-party prior authorization requests, including complex oncology and specialty drug authorizations.
Process medication test claims and maximize revenue capture for high-cost take-home medications through external medication authorization.
Communicate with providers, payers, and patients about coverage determinations and appeals.
Initiate, research, complete, submit, and track Patient Assistance Program applications for assigned facilities.
Identify eligible patients for medication assistance and drug recovery programs and secure funding from pharmaceutical manufacturers and foundations.
Manage patient enrollment and ongoing eligibility in medication assistance programs, and maintain application files and documentation.
Maintain pharmaceutical assistance for enrolled patients throughout the prescription period and identify assistance programs using third-party software and manufacturer portals.
Dispense specialty medications and manage the specialty pharmacy dispensing workflow.
Coordinate specialty orders, including cold-chain and time-sensitive oncology agents, and track shipments and deliveries.
Maintain accurate inventory of patient-specific medications provided through assistance programs.
Complete documentation for URAC and ACHC accreditation, including chart audits, temperature logs, and policy-adherence tracking.
Support 340B program compliance and documentation.
Perform insurance audits and monitor outstanding claims to support revenue cycle integrity.
Build and maintain relationships with hospital contacts, providers, and department managers, and inform them of changes affecting medication access and recovery.
Report program status and barriers to maximizing medication access and recovery opportunities to the Assistant Director.
Follow DCH standards, policies, procedures, compliance requirements, and safety practices; perform other duties as assigned.