Manager, Specialty Pharmacy Navigation Services

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

SUMMARY

Reports to the Manager of Specialty Pharmacy Clinical Services. The Manager of Specialty Pharmacy Navigation Services provides operational, strategic, and people leadership for the Specialty Pharmacy Access Services program, including oversight of Pharmacy Technician Navigators embedded primarily within specialty ambulatory clinics.

This role is accountable for standardizing medication access workflows, leading technician performance and development, and partnering with ambulatory and specialty pharmacy leadership to advance patient access, adherence, financial outcomes, and program growth. The Manager of Specialty Pharmacy Navigation Services owns operational dashboards and key performance indicators (KPIs) that demonstrate the impact and value of technician navigator services across specialty care.

PRINCIPAL DUTIES AND RESPONSIBILITIES

Brown University Health employees are expected to successfully model the organization's values of Compassion, Accountability, Respect, and Excellence as these guide our everyday actions with patients, customers, and one another.

People Management & Team Development

• 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 challenge.

Operational Oversight & Workflow Leadership

• Oversees the daily operations of technician navigator services across specialty 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.

Medication Access & Specialty Pharmacy Support

• 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.

Performance Analytics

• 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.

Quality, Accreditation, & Continuous Improvement

• Supports accreditation activities (e.g., URAC, ACHC), including audits and documentation oversight.
• Leads quality improvement initiatives and promotes medication safety reporting.

Strategic Partnership & Program Growth

• 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.
• Perform other duties as assigned.

BASIC KNOWLEDGE

• High school diploma or equivalent required.
• Bachelor's degree in healthcare, business, management, or a related field preferred; an equivalent combination of education and progressively responsible healthcare experience may be considered.
• Working knowledge of pharmacy benefit management, prescription clam processing, medication prior authorization workflows, denials, appeals, and financial assistance processes.
• Strong understanding of healthcare operations, documentation standards, payer requirements, and regulatory considerations impacting medication access.
• Proficiency with electronic health records (EHR), pharmacy or claims management systems, and standard business software applications.

EXPERIENCE

• 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.
• Demonstrated experience leading teams, managing workflows, and using data to drive operational improvements.
• Strong proficiency with EHRs, pharmacy systems, payer processes, and specialty pharmacy workflows.
• Excellent communication, organizational, and change management skills.

SKILLS

• Strong leadership and people management skills with the ability to motivate, develop, and retain high-performing teams.
• Exceptional verbal and written communication skills, with the ability to present complex data and program outcomes t