Medication Access Specialist: Payor & PA Expert

CLS Health; Webster (TX); Sur place; USD 70 000 - 100 000; Plein temps

Avantages offerts par ce poste

401(k) matching

Dental Insurance

Disability insurance

Health insurance

Life insurance

Paid time off

Résumé du poste

CLS Health in Houston, TX is seeking an experienced Medication Access professional to own end-to-end access for specialty and infused medications across the infusion center and pharmacy.

You will manage payer requirements, determine coverage, and ensure a seamless transition from order to first treatment with minimal gaps. The role emphasizes working knowledge of J-codes, biosimilars, and copay assistance programs.

Qualifications

• 3+ years in medication access or specialty pharmacy intake.
• Experience with prior authorizations and payer collaborations.
• Familiarity with biosimilars, J-codes, and payer policies.

Responsabilités

• Receive and review medication orders from providers.
• Determine coverage and patient financial responsibility.
• Route orders for infusion center vs specialty pharmacy.
• Submit prior authorizations and manage appeals.
• Enroll patients in copay cards and PAP programs.
• Coordinate sourcing with pharmacy and distributors.
• Schedule initial treatments and hand off to clinical staff.
• Track authorizations and reauthorizations.

Connaissances

Medication access

Prior authorization

Specialty pharmacy

Formation

Pharmacy technician certification

Outils

Copay portals

PAP programs

Description du poste

CLS Health in Houston, TX is seeking an experienced Medication Access professional to own end-to-end access for specialty and infused medications across the infusion center and pharmacy.

You will manage payer requirements, determine coverage, and ensure a seamless transition from order to first treatment with minimal gaps. The role emphasizes working knowledge of J-codes, biosimilars, and copay assistance programs.