Manager, Specialty Pharmacy Navigation & Access

Rhode Island Hospital; Rhode Island; On-site; USD 110,000 - 150,000; Full time

Job summary

Rhode Island Hospital is seeking a Manager of Specialty Pharmacy Navigation Services to lead technician navigators, optimize access workflows, and drive program growth across ambulatory clinics.

You will partner with pharmacists and clinic leaders to improve patient access, adherence, and financial outcomes while owning dashboards and KPIs to demonstrate impact and ensure compliance with accreditation standards.

Qualifications

• Minimum of 3-5 years of progressively responsible experience in healthcare operations, pharmacy services, medication access, prior authorization, or revenue-cycle related functions.
• Experience in specialty pharmacy, medication access services, prior authorization management, and financial assistance programs strongly preferred.
• Strong proficiency with EHRs, pharmacy systems, payer processes, and specialty pharmacy workflows.

Responsibilities

• Provides direct supervision to Pharmacy Technician Navigators, including hiring, onboarding, performance management, and professional development.
• Establishes clear role expectations, productivity standards, and accountability measures aligned with program goals.
• Conducts routine performance reviews and competency assessments; addresses performance concerns proactively.
• Serves as an escalation point for complex access issues, clinic concerns, or workflow challenges.
• Oversees the daily operations of technician navigator services across ambulatory clinics, ensuring appropriate staffing models, coverage, and workload distribution.
• Develops, implements, and maintains standardized workflows, SOPs, and documentation practices.
• Partners with pharmacists and clinic leadership to ensure coordinated medication access across the continuum of care.
• Identifies and mitigates risks to patient access and adherence.
• Ensures effective support of benefits investigation, prior authorizations, financial assistance, and therapy initiation/continuation.
• Monitors documentation quality, timeliness, and accuracy within EHR and pharmacy systems.
• Maintains awareness of payer policies impacting access and utilization.
• Ensures appropriate escalation to pharmacists for clinical intervention and supports patient retention efforts.
• Leads development and oversight of dashboards and KPIs measuring program performance and impact.
• Analyzes access, authorization, financial assistance, and adherence metrics to identify trends and improvement opportunities.
• Collaborates with leadership and external partners to address denials and optimize processes.
• Supports accreditation activities (e.g., URAC, ACHC), including audits and documentation oversight.
• Leads quality improvement initiatives and promotes medication safety reporting.
• Collaborates with ambulatory and specialty pharmacy leadership to align services with organizational goals.
• Supports program expansion into new clinics and represents operations in leadership forums and projects.

Skills

Leadership

People management

Communication

Change management

Data-driven

EHR systems

Pharmacy operations

Payer processes

Education

Bachelor's degree

High school diploma

Job description

Rhode Island Hospital is seeking a Manager of Specialty Pharmacy Navigation Services to lead technician navigators, optimize access workflows, and drive program growth across ambulatory clinics.

You will partner with pharmacists and clinic leaders to improve patient access, adherence, and financial outcomes while owning dashboards and KPIs to demonstrate impact and ensure compliance with accreditation standards.