Medication Coordinator I

APLA Health; Los Angeles (CA); On-site; USD 75,561,000 - 85,045,000; Full time

Job summary

APLA Health is seeking a Medication Coordinator I at the Mid Wilshire center in Los Angeles to process refills, prior authorizations, and patient assistance program applications under supervision of the Medication Coordination Manager.

This role requires a California Pharmacy Technician license, 6 months of clinical pharmacy experience, and knowledge of insurance eligibility processes. Occasional travel to other sites and some weekend/evening work may be required.

Qualifications

• High school diploma or GED required.
• California Pharmacy Technician license required.
• 6 months experience as a Pharmacy Technician in a clinical primary care setting.
• Certification to pass 90 day probationary period required.

Responsibilities

• Obtain prior authorizations (PA) for medications.
• Contact insurance carriers to verify medication eligibility.
• Request and track prior authorizations; facilitate appeals as needed.
• Assist with Patient Assistance Program applications and enrollment.
• Document communications with insurers and pharmacies.
• Maintain knowledge of in-house pharmacy software and processes.
• Travel to other APLA Health sites as needed.

Skills

Multitask

Work independently

Communication skills

Team collaboration

Education

High school diploma or GED

California Pharmacy Technician license

PTCB or ExCPT certification

CMA / AAMA / CCMA / NCMA certification a plus

Job description

Job Details

Job Location: APLA Health Center Mid Wilshire - Los Angeles, CA 90036, Position Type: Full Time, Education Level: High School, Salary Range: $26.37 - $29.68 Hourly, Job Shift: Day: 8am - 5pm, Job Category: Health Care, Requisition #: 51516

Status: Full-time, Non-Exempt

Schedule: Monday - Friday, 8AM - 5PM

Onsite or Hybrid: Onsite

POSITION SUMMARY

Under the direct supervision of the Medication Coordination Manager, the Medication Coordinator I will process and track all request for refills, prior authorizations, and patient assistance program. The Medication Coordinator I will perform their duties within the established standards of care, policies and procedures of APLA Health & Wellness.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Obtain prior authorizations (PA) for medications.
• Contact insurance carriers to verify medication eligibility and requirements.
• Request, track and obtain prior authorizations from insurance carriers. Facilitate appeals as needed.
• Request, and track medications requested via the patient assistance program.
• Communicate any insurance changes or trends among the team. Provide updates to local, state, & federal benefits. Gather feedback as provided and relay to program leads.
• Clearly document all communications and contacts with insurance companies, PBOs and pharmacies.
• Stay up to date on all avenues of medication access for patients, including public benefits and programs that may serve as payers of last resort. Evaluate patient candidacy appropriately. Facilitate enrollment of qualifying patients, coordinating with other team members if necessary.
• Complete and manage forms/applications to process medications via the Patient Assistant Program, delegate as appropriate.
• Maintain patients informed on status of patient assistance program, PAs approvals or denials and document in patients electronic health record.
• Process refill medications request
• Provide medication information and education to patients, following established protocols and guidelines.
• Document pertinent patient information following established protocols.
• Adheres to all OSHA PPE safety requirements.
• Maintain working knowledge of in-house pharmacy software platform in order to readily acquire prescription claims information.
• Promotion of pharmacy services to APLA patients.
• Perform data processing when working in pharmacy as typist or clerk.
• Participate in case conferences as needed.
• Will travel to other APLA Health sites as needed.

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

Qualifications: REQUIREMENTS:

Training and Experience:

• High school diploma or GED required.
• California Pharmacy Technician license required.
• 6 months experience as a Pharmacy Technician in a clinical primary care setting required.
• Minimum 6 months experience evaluating eligibility, including both commercial and public benefits.
• Certification upon hire date or within 90 days of hire through Pharmacy Technician Certification Board (PTCB) or Exam for the Certification of Pharmacy Technician (ExCPT) required.
• Certification required to pass 90 day probationary period.
• Current Medical Assistant certificate is a plus
• Certification through American Association of Medical Assistants (CMA/AAMA), National Healthcareer Association (CCMA), American Medical Technologists (RMA), or National Center for Competency Testing (NCMA) is a plus.
• Experience working in a nonprofit ASO environment a plus; specific training/experience with HIV/AIDS-related issues a plus.

Knowledge of:

• Knowledge and experience working with target populations, including individuals who share injection paraphernalia, gay and non-gay identified men, youth, women, and transgender individuals a plus.
• HIPAA certified and knowledge of informed consent.
• Knowledge of medical terminology.
• Knowledge of MSDS and emergency treatments.

Ability to:

• Ability to use computerized patient care systems.
• Work in dependently with minimal direction.
• Work effectively with diverse staff, volunteers and professionals.
• Be at ease and work with a diverse group (ethnic, class, gender, sexual orientation) of individuals who may hold a wide range of opinions regarding prevention needs.
• Engage in community/coalition building.
• Multitask.
• Meet multiple deadlines in a rapidly changing environment
• Maintain patient confidentiality.
• Ensure that services have the following qualities: 1) nonjudgmental 2) are harm reduction focused 3) are sex positive 4) are LGBT positive.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

Special Requirements:

Must possess a valid California driver’s license; proof of auto liability insurance; and have the use of a personal vehicle for work related purposes.

Some weekend/evening work may be required. Local travel (within LA County) is required and some out-of-town and national travel may be required.

COVID-19 and Booster or Medical/ Religious exemption required.

Equal Opportunity Employer.