Manager, Medication Access & Specialty Pharmacy Operations

ebnhc; Boston (MA); On-site; USD 110,000 - 140,000; Full time

Job summary

NeighborHealth in Boston is seeking a Manager, Medication Access & Specialty Pharmacy Operations to lead day-to-day medication access and specialty pharmacy services, ensuring timely, affordable, and clinically appropriate medications.

You will oversee prior authorizations, benefit investigations, financial assistance, and specialty workflows, while maintaining accreditation standards (ACHC and URAC) and collaborating with providers, payers, and operations.

Qualifications

• Experience leading medication access and specialty pharmacy operations.
• Knowledge of prior authorization, benefit investigations, and financial assistance processes.
• Ability to drive accreditation readiness (ACHC, URAC) and improve workflows.

Responsibilities

• Lead daily operations of medication access and specialty pharmacy services.
• Oversee prior authorizations, benefit investigations, financial assistance, and workflows.
• Monitor quality metrics and drive continuous process improvements.
• Collaborate with providers, payers, and operational partners to optimize access to therapy.

Skills

Leadership

Operations Management

Healthcare Compliance

Team Coaching

Stakeholder Collaboration

Job description

Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center!

As one of the largest community health centers in the country, NeighborHealth is proud to serve the greater Boston area with a strong commitment to the health and well-being of our patients and communities.

Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential support staff who keep our operations running smoothly - every role at NeighborHealth is vital. Together, we're advancing medicine and delivering the best care experience for our patients and community!

To learn more about working at NeighborHealth and our benefits, please visit out our Careers Page .

Time Type: Full time

Department: Clinical Pharmacy

All Locations: 10 Gove Street - Taylor Building

The Manager, Medication Access & Specialty Pharmacy Operations is responsible for the day-to-day leadership and oversight of medication access and specialty pharmacy services at NeighborHealth. This role ensures patients receive timely, affordable, and clinically appropriate medications by leading operational workflows, supporting specialty pharmacy compliance, and overseeing a high-performing medication access team. Working closely with providers, clinical teams, payers, and operational partners, the Manager drives efficient access to therapy, removes barriers to care, and supports exceptional patient outcomes. This position plays a key role in optimizing medication access services, improving operational performance, and advancing NeighborHealth's commitment to equitable, patient-centered care. Lead the daily operations of medication access and specialty pharmacy services to ensure patients receive timely, affordable, and clinically appropriate medications. Oversee prior authorization, benefit investigation, financial assistance, and specialty medication workflows while maintaining compliance with accreditation and regulatory standards. Supervise and develop medication access staff, establish operational performance expectations, and drive continuous process improvement. Partner with providers, clinical teams, payers, and operational stakeholders to remove barriers to care, improve access to therapy, and support exceptional patient outcomes. Monitor operational performance metrics and implement solutions that enhance efficiency, quality, and equitable access to medications across the organization.

The successful candidate will be able to perform the following responsibilities:

Specialty Pharmacy Operations & Compliance

• Manage daily specialty pharmacy operations to ensure compliance with organizational policies, regulatory requirements, and accreditation standards, including ACHC and URAC.
• Maintain and continuously improve policies, procedures, and standard operating workflows supporting medication access and specialty pharmacy services.
• Lead operational readiness activities for specialty pharmacy accreditation programs, including ACHC and URAC documentation review, audit preparation, survey readiness, and corrective action implementation.
• Monitor quality, compliance, and service metrics to identify opportunities for operational improvement, risk mitigation, and ongoing accreditation compliance.
• Collaborate with pharmacy leadership to support ACHC and URAC accreditation activities and ensure adherence to established quality and performance standards.

Medication Access Operations & Team Leadership

• Supervise, coach, and develop medication access pharmacy technicians and liaisons, fostering a culture of accountability, collaboration, and service excellence.
• Oversee daily medication access operations, including workload distribution, workflow management, and prioritization of patient access needs.
• Ensure timely completion of prior authorizations, benefit investigations, coverage determinations, financial assistance enrollment, and other medication access activities.
• Establish, monitor, and optimize operational performance metrics, productivity standards, and turnaround time expectations.
• Serve as the primary escalation point for complex medication access issues, including denials, appeals, peer-to-peer reviews, medical exceptions, and payer-related challenges.
• Identify workflow barriers and implement process improvements to reduce delays in therapy initiation and enhance the patient and provider experience.
• Partner with pharmacy leadership to support staffing, onboarding, training, performance management, and professional development initiatives.

Formulary Management & Access Support

• Monitor payer formulary updates, coverage policies, and utilization management requirements across commercial, Medicaid, and Medicare plans.
• Develop and maintain processes that support medication access, co