Medication Access Navigator

Grady Health System; Atlanta (GA); On-site; USD 30,000 - 47,000; Full time

Job summary

Grady Health System is seeking a Medication Access Coordinator to help patients gain access to medications and devices, while maximizing hospital savings and revenue. The MAC designs and monitors access plans and communicates results to the care team with EMR documentation.

The role requires navigating insurance, prior authorizations, and patient assistance programs, coordinating with social services, and supporting pharmacy operations and reporting.

Qualifications

• High School Diploma or GED required.
• Associate's degree or pharmacy technician program/CPhT preferred.
• Three (3) years of experience as retail pharmacy technician, medication access coordinator, or equivalent position.
• Five (5) years of experience preferred.
• Experience with Epic EMR; writing progress notes and completing prior authorization requests via phone/portal.
• Microsoft Office proficiency with Excel and Access.

Responsibilities

• Conduct patient insurance, benefits and financial verification by directly communicating with patients.
• Complete prior authorization forms, negotiate authorization status with insurers and track status of prescription approval.
• Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance.
• Assist in the preparation of medical necessity and appeal letters.
• Facilitate prescription filling and aid in patient adherence to medication therapy.
• Conduct research of financial information in EHR and external systems to identify qualifying patients for medication/device access.
• Schedule and manage appointments to include clinical pharmacists and/or providers.
• Submit prescription claims to PBMs to assess medication coverage and PA status; document in EMR.
• Facilitate communication between providers and patients (medication pick up, refill reminders, PA/PAP status, lab orders, scheduling, reminders).
• Maintain current knowledge of manufacturer indigent patient program criteria and communicate changes.
• Maintain records and statistics for evaluation, cost study and program analysis.
• Identify payor sources for medications/devices (insurance coverage, manufacturer PAPs, programs, foundations).
• Complete face-to-face or telephone interviews with patients to assess medication access.
• Coordinate document assembly for audits; coordinate patient foundations for copay assistance.
• Assist patients in completing applications for Low Income Subsidy via SSA.
• Manage invoice process for PAP access.
• Complete patient eligibility analysis and determine action needed for access.

Skills

Strong organizational skills

Problem-solving

Report analysis

Medical terminology knowledge

Education

High School Diploma or GED

Associate's Degree or Pharmacy Technician program/CPhT

Tools

Epic

Excel

Access

Job description

Grady Health System is seeking a Medication Access Coordinator to help patients gain access to medications and devices, while maximizing hospital savings and revenue. The MAC designs and monitors access plans and communicates results to the care team with EMR documentation.

The role requires navigating insurance, prior authorizations, and patient assistance programs, coordinating with social services, and supporting pharmacy operations and reporting.