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Pharmacy Medication Access Specialist, MAC - Cardiology Service Line

$ Sign-On Bonus Eligible
Winston Salem, NC, United States
Job ID: 143101
Job Family: Pharmacy Services
Status: Full Time
Shift: Day
Detailed Shift and Schedule: 1st shift (0800-1900, hrs vary based on clinic needs), M-F, WE/HOL TBD
Job Type: Regular
Department Name: 12531096832079-Country Club Cardiology

Overview

Job Summary: Activities to support the Medication Access Center (MAC). The MAC will serve as the hub for medication prior authorizations associated with key service lines within the medical center as well as several primary care clinics across various campuses. Medication Access Specialists are responsible for providing front line, direct contact with members, pharmacies and providers. They are responsible for supporting the prior authorization process with a full understanding of procedures related to verbal and electronic prior authorizations and can apply new processes and changes to existing PA processes. Medication Access Specialists will complete the medication prior authorizations for specific medications utilizing either pharmacy or medical benefits. This role will also have a key component in assisting with financial assistance for medication access as needed.  Medication Access Specialists must have strong customer service, communication, computer, and data entry skills. Attends periodic area meetings.  Attends required in-services and skills development courses and maintains technician certification.  This individual, like all department employees, will be expected to uphold the hospital’s key values and to be a team player at all times.

Primarily responsible for assisting with all aspects of medication access, including but not limited to collaboration with healthcare teammates, communication with patients, addressing and resolving medication-related needs, completing necessary reporting and/or auditing, and conducting and completing necessary third party (insurance) requests, as applicable. 

Position Highlights:

  • Full-Time, Days
  • 1st shift (0800-1900, hrs. vary based on clinic needs), M-F, weekend/holidays TBD
  • Winston Campus
  • $6,000 sign-on bonus eligible position for qualified candidates!   Click here for more information!

What We Offer:

  • Day 1 Health Coverage: Choose from either copay or HSA-eligible health insurance options with coverage starting on your first day of work.   
  • Generous PTO: Accrual starts at 25 days/year, to be used for vacations, sickness, holidays, and personal matters. 
  • Education: Eligible for our Prepaid College Tuition Assistance program (up to $5,250/year)!
  • Wellness Incentives: Up to $1,350/year in wellness incentives through our LiveWELL program.
  • Parental Benefits: Six weeks paid birthing-mother maternity leave & four weeks paid parental leave for non-birthing parents. 
  • Retirement: Up to 7% employer-paid retirement contributions.

How You’ll Impact Patient Care:

Your responsibilities may include, but are not limited to:

  • Navigates various options for receiving prior authorization requests and further utilizing systems to find resources that best fit the patient’s needs, as applicable.
  • Provides assistance to a subset of patients by completing Patient Assistance Program (PAP) applications and co-pay assistance applications.
  • Assists patients by explaining the medication access process, which may include completing applications and reviewing documents required to complete the application.
  • In collaboration with pharmacists, completes medication reconciliation, reviews prescription claim history for medication adherence and documents findings in the electronic health record, as applicable. Also available to patients and families to triage questions regarding medication access needs. 
  • Verifies patient insurance benefits to minimize patient cost.
  • Completes PAP and copay assistance applications, records qualitative monthly/quarterly feedback, refill reminders and medication shipment scheduling, and patient re-enrollment in appropriate assistance programs, as appropriate.
  • Apply co-pay assistance payments to the appropriate patient account, as applicable. 
  • Performs data entry and prepares tracking reports for both internal and external stakeholders.
  • Garners and maintains knowledge of Health Plan compliance requirements, healthcare operations, and medical terminology.
  • Efficiently determines a patient's ability to utilize enterprise pharmacy services.  Routes prescriptions to appropriate pharmacy, as necessary.
  • Supports the development of methods of communication and coordination with patient care team to ensure timely and accurate fulfillment of orders for patient requests and clients.
  • Maintains updated knowledge and skills and contributes to the education of others.
  • Participates in planning processes by establishing personal goals to support quality improvement efforts and contributes to the achievement of departmental objectives.
  • Audits own performance and recommends objectives and standards of performance.
  • Contributes positively to execution of pharmacy department initiatives.
  • Accepts assignments of tasks from other pharmacy teammate roles when workload dictates.
  • Any other duties as assigned.

What You Will Need 

  • High school diploma or GED equivalent required.

Nice To Have (Not Required) 

  • Associate degree or bachelor’s degree preferred. 
  • Three years’ pharmacy experience and two years call center or customer service experience highly preferred.
  • Retail pharmacy or healthcare/medical group experience and two years of healthcare related billing preferred. 
  • Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcareer Association (ExCPT) preferred.
  • North Carolina Board of Pharmacy registration required within 30 days of employment. 
  • Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcareer Association (ExCPT) within 180 days of employment.
  • PTCB Billing and reimbursement certificate or similar certification preferred.

Where You Will Work:

  • Working in healthcare in Winston-Salem, North Carolina, is a rewarding and dynamic experience. This vibrant city is home to renowned healthcare institutions making it a hub for medical professionals and healthcare innovation.
  • As a healthcare professional in Winston-Salem, you'll have the opportunity to provide top-notch care to a diverse and engaged community. The healthcare industry here is characterized by a commitment to patient-centered care, cutting-edge medical research, and a collaborative spirit among healthcare providers.
  • Winston-Salem offers a high quality of life with a cost of living that's lower than in many other major cities. You'll find thriving arts and culture scene, beautiful parks, and a strong sense of community. The city's commitment to healthcare extends beyond the hospital walls, with initiatives aimed at improving public health and wellness.
  • Whether you're drawn to clinical care, research, or administration, working in healthcare in Winston-Salem, NC allows you to be part of a healthcare environment that values excellence, compassion, and the well-being of the community. Join us in contributing to the health and vitality of Winston-Salem, where healthcare is not just a profession but a calling.