Pharmacy Access Specialist - Hybrid Remote Madison or Monroe WI

SSM Health at Home, WI; Monroe (WI); Remote; USD 40,000 - 50,000; Full time

Job summary

A leading health provider is seeking a Pharmacy Access Specialist in Monroe, WI. This entry-level position focuses on enhancing patient access to necessary pharmaceuticals and managing insurance benefits. Ideal candidates will exhibit strong communication skills and advocacy for patient access, while being supported by a collaborative team environment.

Benefits

Paid Parental Leave

Flexible Payment Options

Upfront Tuition Coverage

Qualifications

• No experience required, but knowledge in health care is beneficial.
• Fostering client relationships and understanding pharmacy benefits.

Responsibilities

• Liaise between medical staff, pharmacies, and patients to improve care continuity.
• Review patient demographics and insurance status to identify barriers.
• Conduct benefits investigations and facilitate prior authorizations.

Skills

Communication

Patient Advocacy

Insurance Knowledge

Education

Bachelor's degree or equivalent years of experience

Job description

Pharmacy Access Specialist - Hybrid Remote Madison or Monroe WI

Pharmacy Access Specialist - Hybrid Remote Madison or Monroe WI

3 weeks ago Be among the first 25 applicants

Job Highlights

At SSM Health, we know the healing power of presence begins with compassionate employees like you. As a Pharmacy Access Specialist, you’ve chosen a career where patients matter—a lot. The Pharmacy Access Specialist plays an integral role in our care team, and we see it as a partnership. Our mission and values put the patient first and place you in a position to improve each day.

It's more than a career, it's a calling

WI-Monroe Clinic Hospital

Worker Type

Regular

Job Highlights

At SSM Health, we know the healing power of presence begins with compassionate employees like you. As a Pharmacy Access Specialist, you’ve chosen a career where patients matter—a lot. The Pharmacy Access Specialist plays an integral role in our care team, and we see it as a partnership. Our mission and values put the patient first and place you in a position to improve each day.

In return, you can expect a work environment where employees feel valued, respected, and free to express themselves; each employee finds meaning in work, leveraging skills, and talents toward a greater purpose; teamwork and collaboration are encouraged, while management is supportive.

• Department: Pharmacy Access Supporting the SSM Health’s Monroe Clinic
• Schedule: Full Time, Day Shift, Mon-Fri 8am-4:30pm.
• No Weekends
• Starting Pay: 23.86 (Offers are based on years of experience and equity for this role.)
• Shift Differentials: Evenings-1.50, Nights-2.25, Weekends 2.15
• Location: Can be based in either Madison or Monroe Wisconsin
  
  

If each patient’s needs, wants, and goals matter to you… then we’d love to learn more! Please fill out your application today.

Job Summary

Increase patient access and adherence to medically necessary pharmaceuticals by managing patient’s insurance benefits and utilizing established patient assistance programs. Provides value-added services by developing client-based relationships with clinical staff and patients, presenting pharmacy service options through customized financial analysis, and facilitating information gathering for program enrollment (patient assistance and indigent programs).

Primary Responsibilities

Job Responsibilities and Requirements:

• Serves as the liaison between the medical staff, outpatient pharmacies, insurance providers and patients to improve communication and continuity of care.
• Review patient demographics, medication history, and insurance status to identify socioeconomic barriers, opportunities for intervention and eligibility for prescription assistance.
• Improves patient service experience through the provision of benefits investigations and conducting prior authorization services. Develops a thorough understanding of payer reimbursement and patterns for pharmacy and medical claims with third parties.
• Serves as primary ambulatory pharmacy resource to facilitate access to prescription and medical benefit medications. Including but not limited to; formulary/coverage issues, copay issues, patient assistance program eligibility, and other indigent programs.
• Coordinates services with appropriate departments and internal patient care team members regarding patients who have limited financial resources for paying for medications and facilitates medication access to support discharge preparations.
• Interacts with hospital and clinic employees, including but not limited to pharmacists, clinical staff, fiscal personnel, department managers, access services staff, coding staff, and billing assistants. External contacts include but are not limited to third party payers, manufacturers, prescription benefit management companies, external pharmacy personnel, and referring providers and their support staff.
• Reviews complex insurance situations in order to educate patients, providers, and clinic staff on how to follow appropriate next steps to get access to prescription and medical benefit information.
• Performs other duties as assigned.
  
  

EDUCATION

• Bachelor's degree or equivalent years of experience and education
  
  

Experience

• No experience required
  
  

Physical Requirements

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.
  
  

Required Professional License And/Or Certifications

State of Work Location: Illinois

• Pharmacy Technician, Registered - Illinois Department of Financial and Professional Regulation (IDFPR)
  
  

State of Work Location: Missouri

• Pharmacy Technician - Missouri Division of Professional Registration
• Or
• MO Registration Application and Fingerprint Process Complete AT TIME OF HIRE - Missouri Division of Professional Registration
• And
• FUTURE - Pharmacy Technician, Registered within 6 months - Missouri Division of Professional Registration
  
  

State of Work Location: Oklahoma, Wisconsin

• N/A
  
  

Work Shift

Day Shift (United States of America)

Job Type

Employee

Department

7721000165 Pharmacy Access

Scheduled Weekly Hours

40

Benefits

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

• Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
• Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.
  
  

Explore All Benefits

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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