Specialty Medication Access Coordinator
About The Position
The In-Clinic Specialty Medication Access Coordinator fulfills core job functions while providing dedicated coordination and advanced support for one or more specialty clinics. The role supports healthcare providers and patients by helping ensure timely access to complex, high-cost, and specialty therapies essential to patient care and quality outcomes. Serving as the primary on-site liaison between providers, patients, and pharmacy, the coordinator helps increase utilization of BILH pharmacy services by identifying patients who may benefit from integrated pharmacy support and educating providers and patients about internal pharmacy coordination. In collaboration with the Medication Authorization & Access team, the coordinator independently manages prior authorizations, insurance approvals, and financial assistance processes, resolving complex access barriers in real time. This patient-facing role calls for clinical insight, operational efficiency, and strong communication to support patient outcomes, provider satisfaction, and pharmacy integration across the BILH network.
Requirements
- High school diploma or GED.
- Massachusetts Pharmacy Technician License from the Massachusetts Board of Pharmacy.
- PTCB National Certification.
- Five years of related work experience in specialty pharmacy and pharmacy prior authorization.
- Proven track record of successfully managing stakeholder relationships and driving service adoption.
- Ability to make decisions guided by precedents, policies, and objectives, including recommendations on matters affecting a department or functional area.
- Ability to analyze varied problems using direct observation, knowledge, skills, and general precedents.
- Ability to follow procedures, set priorities, organize work within general guidelines, and seek assistance in difficult or unpredictable situations.
- Clear and effective written communication in English with internal and external customers.
- Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families, and external customers.
- In-depth knowledge of concepts, practices, and policies, and ability to apply them in complex situations.
- Ability to lead small projects or work groups, foster a collaborative and respectful environment, and improve workflows.
- Ability to provide professional, respectful, service-oriented customer care using active listening and problem-solving skills, including remaining calm in stressful situations.
Nice To Haves
- Leadership or training experience within a pharmacy, clinic, or medication access program.
- Familiarity with 340B and integrated health system pharmacy models.
- Comprehensive clinical knowledge of therapies used in specialty disease states such as MS, RA, GI, transplant, oncology, hepatitis C, or infectious diseases including HIV.
- Advanced Certificate Pharmacy Technician credential (CPhT-Adv).
- Experience implementing process improvement or access optimization initiatives within a health system or specialty pharmacy setting.
- PACS certification.
Responsibilities
- Serve as the on-site subject matter expert for providers, clinic staff, and pharmacy teams on prior authorizations, reimbursement, and patient assistance for complex and specialty therapies.
- Independently manage pharmacy and medical benefit authorizations, identify formulary alternatives, and help secure timely approvals to support continuity of care.
- Oversee insurance authorization and financial clearance for specialty and infusion medications, provide cost estimates, and prevent treatment delays.
- Coordinate patient enrollment and ongoing support in manufacturer or financial assistance programs to help ensure affordability and uninterrupted therapy access.
- Lead administration of the Employee Variable Co-Pay Program and advocate for patients through direct collaboration with manufacturers, PBMs, and specialty pharmacies.
- Maintain proactive communication with patients, providers, and pharmacies to resolve access barriers efficiently.
- Act as the primary point of contact for benefits, clinical coordination, and program eligibility inquiries, streamlining processes across stakeholders.
- Drive operational efficiency and quality improvement by independently resolving complex cases and advancing clinic best practices.
- Develop and maintain strategic relationships with payers, manufacturers, and specialty partners to anticipate and navigate policy or coverage changes.
- Mentor and train Medication Authorization and Access team members and support cross-coverage across specialty and primary care clinics.
- Identify patients who may benefit from integrated pharmacy support and educate providers and patients on internal pharmacy coordination.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
