Be a part of a world-class academic healthcare system at UChicago Medicine as an Ambulatory Medication Access Coordinator in the Meds2Beds Pharmacy. In this role you will be responsible for completing necessary functions to ensure optimal reimbursement for high cost, take home medications for patients receiving care in UCMC ambulatory clinics. You will also be responsible for assistance with conducting and completing necessary third party (insurance) prior authorization requests and associated services related to high cost medications, maximizing efficiency for patients and clinic staff.

Sign-On Bonus Eligible!

Job Summary

The Ambulatory Medication Access Coordinator Educator is responsible for pre-screening patients for viable payment sources, managing reimbursement issues associated with high cost take-home medications, identifying opportunities for improving reimbursement from payers, compiling reports for contract optimization, completing the necessary paperwork for prior authorizations, and conducting retrospective utilization reviews on cases of payment denials or insufficient reimbursement. The Ambulatory Medication Access Coordinator – Educator (AMAC-E) will also coordinate and oversee training and competency in Ambulatory Medication Access Coordinators (AMAC). The Ambulatory Medication Access Educator will facilitate the development of Ambulatory Medication Access Coordinators’ training experiences and competencies. They will work collaboratively with peers and members of the management team to set and model the standard for excellence for pharmacy practice and design pharmacy training programs to collaboratively advance the Comprehensive Pharmacy Practice model.

Essential Job Functions:

• Improve patient service experience and maximize UCMC pharmacy revenue through provision of prior authorization services on behalf of clinics for select high cost medications.
• Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete prior authorization forms, negotiate authorization status with insurers, track status of prescription approval and when necessary, alert clinical pharmacists of denials or nonresponse.
• Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance. Assist pharmacists with preparing letters of medical necessity and coordinating peer-to-peer conferences.
• Enter patient information on tracking forms and in computer software.
• Expedite clinic workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, and clinic staff.
• Communicate and collaborate regarding patient therapy interruptions, additional therapy monitoring requirements, and alternative care delivery setting options.
• Facilitate adherence to medications by ensuring that patients receive prescribed medications in a timely manner.
• Make scheduled calls to patient to obtain clinical information regarding patient’s experience with therapy and to process prescription refills.
• Document and triage patient problems with therapy to the appropriate pharmacist; assure documentation of problem and follow-up with patient and assist with coordination of filling, packaging and delivery of prescriptions.
• Coordinate synchronization of patients’ prescriptions.

Required Qualifications:

• Associate or Bachelor’s degree.

• 3 to 5 years of pharmacy technician experience in a retail pharmacy Exceptional aptitude or knowledge may be considered in lieu of experience.

• Current or Eligibility for Illinois Pharmacy Technician Licensure.

• Knowledge of medication reimbursement preferred.
• Knowledge of healthcare/prescription insurance billing, prior authorization, coding preferred.
• Knowledge of and ability to use computers and a variety of computer programs including word processing, database management and spreadsheets.
• Strong oral and written communications skills.
• Ability to effectively manage conflicts and resolve problems.
• Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction.
• Ability to function effectively in a fast-paced and changing environment with multiple priorities.
• Knowledge of and ability to perform insurance carrier/managed care review.
• Strong teaching skills or supervisory experience

Position Details:

• Job Type/FTE: Full-Time (1.0 FTE)
• Shift: Day Shift
• Unit/Department: DCAM Pharmacy
• CBA Code: Non-Union

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