Pharmacy Medication Authorization and Access Manager

BILH Performance Network; Westwood (MA); On-site; USD 94,993 - 117,998; Full time

Job summary

BETH ISRAEL LAHEY HEALTH’s Pharmacy department in Westwood is seeking an Medication Authorization and Access Manager. This role oversees prior authorizations, financial clearance, and patient assistance programs, while supervising staff and ensuring timely access to medications.

You will work with analytics teams and leadership to maintain high-quality service. The position requires an associate degree (Bachelor's preferred) and a Certified Pharmacy Technician license, with 3–5 years of

Qualifications

• Associates degree required; Bachelor's degree preferred.
• License Certified Pharmacy Technician required.
• 3–5 years related work experience and 1–3 years supervisory/management experience.
• Strong understanding of insurance adjudication and prior authorizations; ability to present quantitative/qualitative analysis.

Responsibilities

• Oversee prior authorization for prescriptions and financial clearance for infusion/injection services.
• Manage Patient Assistance Programs and related processes.
• Develop, implement, and maintain department policies and procedures.
• Direct supervision of staff; coordinate scheduling, training, and performance evaluations.
• Collaborate with Pharmacy Leadership and Ambulatory Pharmacy Services to meet goals; ensure communication with clinics, patients, and providers.

Skills

Prior authorization

Insurance adjudication

Supervisory experience

Microsoft Office

Data analysis

Communication skills

Healthcare billing

Education

Associate degree

Bachelor's degree

Tools

Outlook

Word

Excel

PowerPoint

Access

Job description

# Pharmacy Medication Authorization and Access ManagerWestwood, MA • BILH Pharmacy • Full-time • DayShare job:Apply now**When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.**Responsible for managing all aspects of the Medication Authorization and Access team which includes prior authorizations/financial clearance, patient assistance program, and denial management. The manager will lead, support, and manage all the staff and functions of the department to ensure patients can access the drugs they need.**Job Description:*** Oversees the functions related to prior Authorization for prescriptions, financial clearance for hospital based infusion/injection services and our Patient Assistance Programs.* Responsible for the development, implementation, administration, and quality of the groups systems, policies and procedures.* Assumes direct supervision of the staff and their performance.* Coordinates, communicates, maintains schedules, trains, and monitors the development and evaluation of their staff. Works collaboratively as part of the Pharmacy Corp leadership team and in particular the Ambulatory Pharmacy Services team to achieve our goals and purpose.* Ensures processes consistently communicate with staff, patients, and providers to ensure proper and timely delivery of medications.* Ensures strong working relationships with clinics and physicians to ensure we are providing the level of service to support their patients.* Works collaboratively with our Data analytics and financial teams to ensure that infusions and injections are being paid correctly.* Participates as a member of the Quality Management Committee to provide quality management oversight to the pharmacy operations and client satisfaction.**Required Qualifications:**1. Associates degree required. Bachelor's degree preferred.2. License Certified Pharmacy Technician required.3. 3-5 years related work experience required and 1-3 years supervisory/management experience required.4. Strong understanding of insurance and adjudication processes with a robust understanding of prior authorizations through pharmacy and medical benefits. Demonstrated ability to produce quantitative and qualitative analysis in a presentation format. Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.**Pay Range:**$94,993.60 USD – $117,998.40 USDThe pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.## As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.## More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.## Equal Opportunity Employer/Veterans/Disabled### **Job details*** **Employment:** Full-time* **Hours/Week:** 40* **Shift:** Day* **Category:** Pharmacy* **Pay Range:** $94,993.60 USD - $117,998.40 USD* **FLSA:** Exempt* **Req ID:** JR100105