Medication Case Manager

Community Health Centers of the Central Coast, Inc.; Paso Robles (CA); On-site; USD 30,307 - 33,062; Full time

Job summary

Community Health Centers of the Central Coast, Inc. is seeking a Medication Case Manager in the Medical department to support patients in obtaining and using essential medications. The role operates under non-exempt status with a wage range stated for California.

The position involves reviewing prescriptions for coverage, data entry, patient resource referrals, and coordinating with care teams to ensure timely renewals and adherence to treatment plans. Strong HIPAA compliance is expected.

Qualifications

• High school diploma or GED required; pharmacy/clinic experience preferred.
• Ability to read, analyze, and interpret documents; HIPAA knowledge preferred.
• Experience with word processing, spreadsheets, email; EHR experience required.

Responsibilities

• Reviews prescriptions to determine potential sources of financial coverage and prior authorization.
• Enters data such as patient name, prescribed medication, cost, income level and eligibility for medication assistance programs.
• Assists patients in finding links to health resources and programs; ensures annual review with primary provider.
• Communicates with care teams to ensure documentation for medication renewals and refills.
• Maintains inventory of medication samples and processes refill requests.

Skills

Communication skills

Medication knowledge

Data entry

Customer service

Education

High school diploma or GED

Tools

EHR system

Google Suite

Microsoft Office

Job description

Job Title: Medication Case Manager

Department: Medical

Reports To: Health Center Manager/Clinical Services Supervisor

FLSA Status: Non-Exempt

Wage Range that the Company Expects to Pay: $22.50 - $24.81 per hour

Summary

Under the direct supervision of the Health Center Manager and clinical supervision of the Clinical Services Supervisor, the Medication Case Manager will assist patients in the procurement and ongoing use of essential medications to improve health and well-being. It is the primary purpose of CHCCC to provide the highest quality of total care possible to the patient population it serves. Such a level of quality depends ultimately on the staff's desire and ability to work together, individually, and as a team. The employee is expected to be professional, punctual, maintain regular attendance, cooperative, motivated, and organized at all times.

ESSENTIAL DUTIES AND RESPONSIBILITIES

include the following. Additional duties may be assigned with or without prior notice.

• Reviews prescription issued by providers to determine potential source for financial coverage and prior authorization.
• Enters data such as patient name, prescribed medication, cost, income level and potential eligibility for medication assistance programs.
• Assists patients in finding links to additional health resources, Health Educators, smoking cessation programs and physical fitness programs.
• Ensures patients are following up with their primary provider at least once a year to review medications.
• Communicates with patient care teams to ensure appropriate documentation for medication renewals and refills.
• Accounts for inventory of medication samples on hand.
• Locates and prepares refill requests in provider and staff inboxes.
• Reviews medication refill requests. Enters or loads up the refill request with pertinent information for provider to refill.
• Ensures needed lab tests for prescribed medications adhere to medication guidelines when applicable.
• Adds diagnosis to medication requests when the diagnosis has already been established in the patient’s record.
• Communicates/notifies patients of medications that are ready for pick-up.
• Takes financial and drug histories to assists the pharmacist in the appropriate procurement and monitoring of drug therapy for individual patients, including adherence to the prescribed treatment regimen.
• Reviews records to determine late refill requests and contacts patients to determine the reason for non-adherence.
• Reviews and obtains appropriate information for controlled substance monitoring (example: CURES).
• Assists the 340B department on completion and status of reports, obtains consult notes from specialty providers and updates medication modules with prescriptions prescribed by the specialist.
• Ability to work with high volume of patients, internal/external customers, and deal with frequent changes, delay or unexpected events.
• Demonstrates adherence to and observes all safety policies and procedures, inclusive of infection control rules and regulations.
• Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served (infants, pediatrics, adolescents, adults or geriatrics).
• Demonstrates knowledge of domestic violence, child and dependent abuse protocols.
• Demonstrates cultural sensitivity and competence with patients.
• Maintains and adheres to HIPAA, employee confidentiality, and privileged communications (patient, employee, and corporation).

Supervisory Responsibilities

This job has no supervisory responsibilities.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION And/or EXPERIENCE

High school diploma or GED required. Previous experience working in a pharmacy and/or clinic setting preferred. Must have knowledge of medications and their uses.

Language Skills

Ability to read, analyze, and interpret documents such as safety rules, operating and maintenance instructions, policy and procedure manuals. Ability to respond effectively to the most sensitive inquires or complaints. Ability to write routine reports and correspondence. Ability to speak effectively before groups of patients or employees of organization.

Mathematical Skills

Ability to add, subtract, multiply, and divide into all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY

Ability to apply sound judgment in understanding to carry out instructions in written or oral form. Ability to make appropriate job decisions following standard office policies and past precedents.

Computer Skills

Experience with word processing, spreadsheets, email, and keyboarding required. Google Suite, Microsoft Office skills required. EHR experience required.

CERTIFICATES, LICENSES, REGISTRATIONS

Possession of current, valid, unrestricted California Driver's License (Class C) required. A valid, unrestricted California Pharmacy Technician license or a Pharmacy Technician certificate is preferred. Will consider licensure or certificate in a related field.

Other Requirements

Required to pass a criminal history background check and drug screen upon hire. Annual health examination; annual Tuberculosis skin test clearance or chest x-ray; proof of immunity to MMR, Varicella, and Hepatitis B; proof of Tdap vaccine; during current flu season, must provide proof of influenza vaccine or a signed declination form. If declined, a flu mask is mandatory during flu season. Health screening requirements are subject to change based on CDC recommendations and federal, state/or local public health ordinances.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to sit. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently exposed to moving mechanical parts. The employee is occasionally exposed to risk of electrical shock. The noise level in the work environment is moderate (i.e. clinic setting). Must be able to work in a fast-paced environment.

Must be willing to have a flexible work schedule that may include evenings/weekends, and travel as needed.