Ambulatory Medication Access Coordinator (Specialty Pharmacy), Full-Time, Days

UChicago Medicine; Illinois; Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Sign-on bonus up to $3,000

Job summary

UChicago Medicine is seeking an Ambulatory Medication Access Coordinator to support prior authorizations and insurance related services for high-cost take-home medications in Ambulatory Clinics. You will handle calls, verify benefits, and collaborate with clinicians to optimize reimbursement and patient access.

The role focuses on reducing therapy interruptions by managing insurance issues, enrolling patients in assistance programs, and improving clinic workflows within a remote-hybrid

Qualifications

• 3 to 5 years of pharmacy technician experience in a retail pharmacy.
• Associate's or Bachelor's degree required.
• Current or Eligibility for Illinois Pharmacy Technician licensure.
• Strong oral and written communications skills.
• Knowledge of insurance carrier/managed care review.

Responsibilities

• Handle inbound and outbound phone calls for ambulatory pharmacy patients.
• Perform prior authorization requests for high-cost medications.
• Pre-screen patients for viable payment sources and assist with patient assistance programs.
• Enter and track patient data and forms in computer systems.
• Collaborate with pharmacists, physicians and clinic staff to prevent therapy interruptions due to insurance issues.
• Support enrollment of patients in assistance programs and improve reimbursement processes.

Skills

Pharmacy experience

Communication skills

Conflict resolution

Interpersonal skills

Adaptability

Insurance knowledge

Med reimbursement knowledge

Healthcare billing knowledge

Prior authorization experience

Education

Associate's or Bachelor's degree

Job description

Job Description

Be a part of a world-class academic healthcare system at UChicago Medicine as an Ambulatory Medication Access Coordinator in the Specialty Pharmacy. In this role you will be responsible for handling inbound and outbound phone calls, 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.

Eligible for a Sign-On Bonus up to $3,000
In this role, the Ambulatory Medication Access Coordinator, or AMAC, performs necessary functions to ensure optimal reimbursement for high cost, take home medications for patients receiving care in UCMC Ambulatory Clinics. Other areas of responsibility include handling inbound and outbound phone calls, pre-screening patients for viable payment sources, managing reimbursement issues associated with high-cost, take-home medications, identifying opportunities for improving reimbursement from payers, and completing necessary paperwork for prior authorizations.

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.
• 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.
• Provide exemplary customer service to outpatients across UCMC, including handling inbound and outbound phone calls.
• Observe and understand prescribing trends within UCMC Ambulatory Clinics to identify areas for improved specialty pharmacy contracting.
• Assist with development and implementation of policies and procedures to ensure reimbursement of high-cost medications.
• Performs other duties as requested by leadership.

Required Qualifications

• Associate\'s or Bachelor’s degree
• Current or Eligibility for Illinois Pharmacy Technician licensure
• 3 to 5 years of pharmacy technician experience in a retail pharmacy (exceptional aptitude or knowledge may be considered in lieu of experience.)
• 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

Preferred Qualifications

• Knowledge of medication reimbursement preferred
• Knowledge of healthcare/prescription insurance billing, prior authorization, coding preferred

Position Details

• Job Type/FTE: Full-Time (1.0 FTE)
• Shift: Days
• Work Location: Hyde Park
• Unit/Department: Specialty Pharmacy
• CBA Code: Non-Union

In this role, we anticipate that you will be scheduled to work 8-hour shifts, day shift approximately between the hours of 7am-5:30pm and will not be scheduled for on-call shifts. We anticipate you will be scheduled to work a remote-hybrid schedule, working onsite 1 week every 3-5 weeks. The days of the week that you are scheduled will be Monday-Friday, and no weekends. This is subject to change.

About Us

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities

UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.

As a condition of employment, all employees are required to complete a pre-employment physical, background check, drug screening, and comply with the flu vaccination requirements prior to hire. Medical and religious exemptions will be considered for flu vaccination consistent with applicable law.

Compensation & Benefits Overview

UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position. The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union. Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.