Pharmacy Access Representative III - Specialty Pharmacy Job at University of Rochester (Rochester)

Job Description

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Responsibility

Manages medication coordination and removal of barriers that prevent patients from receiving their medications
Communicates with the prescriber’s office to acquire necessary information to submit prescriptions to the patient’s insurance for approval including prior authorization
Helps enroll patients in financial assistance programs and arrange timely delivery of the medication
Facilitates communication between the patient, pharmacist, insurance, and staff to ensure coordinated care
Maintains expertise on all potential patient assistance programs (PAP), grants, foundations, and coupons relevant to the high-cost drugs prescribed in their assigned area(s)
Analyzes patients that are receiving high-cost medications for potential participation in PAPs
Coordinates with the patient and/or family to obtain necessary information
Enrolls patients in PAPs
Submits all required documentation to the PAP throughout the duration of treatment
Understands and manages the payment process specific to each PAP
Serves as a subject matter expert available to patients, providers, and other staff about financial assistance resources
Collaborates with social services and case management on patient assistance
Coordinates medication and supplies preparation with pharmacy staff to ensure timely delivery
Troubleshoots insurance issues with pharmacists, physicians, and staff to prevent treatment interruptions
Follows up with patients to ensure safe and effective medication use
Documents problems with the medication
Coordinates medication ordering with inventory manager for special orders or low-volume medications
Tracks changes in prescribing trends
Makes scheduled calls to patients to bill prescriptions and set up deliveries
Facilitates adherence to medications by ensuring that patients receive prescribed medications in a timely manner
Provides excellent customer service through the Pharmacy Call Center
Triages patient calls to the appropriate party
Answers incoming calls in a timely manner
Monitors and reconciles patient charge accounts once a month
Remains professional, courteous, and diligent in all interactions with staff and patients/families
Reports errors through the hospital error reporting system (RL solutions) and contributes to quality improvement initiatives
Assists with prescription audits and ensures timely completion of required patient documentation
Assists with the training of new team members in the designated clinical area
Maintains expertise in the current policies of the most common payors for the relevant administered drugs that require prior authorization (PA)
Initiates, documents, and tracks all prior authorization on behalf of the areas to improve patient experience, ensure compliance, and prevent interruptions or delays in treatment

Requirements

Associate’s degrees in a Medical, Secretarial, or related field and 4 years of relevant experience required
Capable of working independently with minimum supervision required
Strong communication skills, problem-solving abilities, and professional presentation required
Demonstrated customer relations skills required
Ability to multi-task, manage many details with accuracy, work under pressure, and maintain a professional attitude required
Completed ASHP-accredited training program or equivalent experience as a pharmacy technician preferred
Certification from a nationally accredited pharmacy technician certification program (Currently PTCB) and maintain ongoing education requirements preferred

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Pharmacy Access Representative III - Specialty Pharmacy

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