Medication Access Coordinator

Job Profile Summary

This role focuses on providing pharmacy related services in a hospital or retail setting. In addition, this role focuses on performing the following Pharmacy Services duties: Delivers pharmaceuticals. Includes professionals who are trained and sometimes licensed to dispense medicine/controlled substances. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. A specialist level role that requires very advanced knowledge of operational procedures and tools obtained through extensive work experience and may require vocational or technical education. Works under limited supervision for non-routine situations and may be responsible for leading daily operations, and trains, delegates and reviews the work of lower level employees, and problems are typically difficult and non-routine but not complex.

Job Overview

Under the supervision of a licensed pharmacist, the Medication Access Coordinators (MACs) assist in the various activities of the Department of Pharmacy. The primary responsibility of the position is to conduct benefit investigations to help patients of Tufts MC increase access to medications. The position is responsible for documentation of all encounters within the EHR, as well as case management software. This position requires frequent communication with providers (MD, RPh, RN, NP, PA) on changes in adherence as well as any financial burden patients may experience. Functions in accordance with standard written procedures, guidelines, and state and federal regulations. Interacts with patients to help improve adherence under the supervision of a pharmacist for patients using our outpatient pharmacy. Incumbents will educate, train and provide oversight for registered, certified, and lead certified pharmacy technicians. Participates in recruiting, scheduling and evaluating other technicians.

Job Description

Minimum Qualifications:

1. High school graduate or equivalent.

2. Certified Pharmacy Technician (CPhT).

3. Massachusetts Pharmacy Technician Registration.

4. Three (3) years of related experience.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

1. Serves as a subject matter expert for medication prior authorizations.

2. Educates / in-services MDs, RNs and NPs on reimbursement changes.

3. Obtains treatment plans and patient demographics to begin insurance verification and authorization process. Works with clinical staff to obtain information necessary to ensure proper documentation and justification for payment.

4. Works with the Medical Records Department to ensure proper documentation and coding.

5. Oversees processes for analyzing benefit requirements and obtaining authorizations as well as medical necessity clearance under the supervision of a pharmacist.

6. In conjunction with a supervising pharmacist, monitors adherence with the goal of improving patient outcomes. Proactively contact patients to notify them of upcoming prescription refills and informs them of prior authorizations or appeals process.

7. Refers patients' concerns requiring clinical interpretation to the appropriate provider (MD, RPh, RN, NP, PA).

8. Resolves patients' payer-related concerns to optimize care.

9. Receives drugs from wholesale distributors and restocks pharmacy drug storage locations.

10. Participates in managing Schedule II, III and IV controlled substance inventories. Identifies and segregate expired drugs.

11. Participates in conducting routine physical inventories of all drug storage locations. Conducts routine inspections and documents storage temperature as required.

12. Helps to maintain financial and regulatory records required by the Medical Center, and by state and federal agencies.

13. Restocks medications into automated drug dispensing machines.

14. Supports filling outpatient prescriptions as allowed by law.

15. Delivers bulk and patient-specific drug products to patient care areas.

16. Repackages and labels pharmaceuticals.

17. Prepares sterile products using proper aseptic technique.

18. Performs calculations required for dosage determinations and drug preparation using the metric system.

19. Participates in gathering and reporting data to support the Department of Pharmacy Quality Programs.

20. Participates in recruiting, hiring, evaluating performance, training, and developing staffing plans for pharmacy technicians and interns.

21. Serves as the triage technician in the central pharmacy. Functions include managing telephone calls, coordinating the work of other technicians and providing operational support to pharmacists.

22. Provides oversight for other technicians and as allowed by law, check the work of other registered and certified technicians.

23. Maintains collaborative, team relationships with peers and colleagues to effectively contribute to the working group and to help foster a positive work environment.

24. Interacts effectively with other members of the healthcare team on a regular basis.

Physical Requirements:

1. Repetitive use of hand and fingers (e.g., use of computer keyboard).

2. Ability to walk or stand for 90% of the shift.

3. Frequent reaching and grasping below, at and above shoulder level.

4. May require lifting and carrying light loads, including boxes, equipment, and stooping or kneeling.

5. Regularly pushing and pulling non-motorized carts (e.g., cart, rolling racks,) weighing 40-60 pounds.

6. Must be physically able to operate equipment used for the job.

Skills & Abilities:

1. Maintains knowledge of the general chemical and physical properties of drugs handled in the pharmacy.