Pharmacy Patient Access Coordinator

SYSTEM West Virginia University Health System; EE. UU.; Presencial; USD 23.000 - 33.000; Jornada completa

Descripción de la vacante

WVU Medicine is seeking a Pharmacy Patient Access professional to coordinate and manage manufacturer free drug programs, interact with providers, office staff, and patients to obtain medication orders and financial information, and submit applications to manufacturer programs. You will review denials, support billing accuracy, and collaborate with the care team to ensure timely patient access.

The role requires knowledge of pharmacy operations, licensure requirements, and strong customer service

Formación

• Education/certification: WV Pharmacy Technician License or Trainee License (WV Board of Pharmacy).
• Nationally Certified Pharmacy Technician (PTCB or NHA) within 15 months of hire.
• Experience in managing manufacturer free drug programs and denials processes.

Responsabilidades

• Manages workflow of manufacturer free drug programs and ensures efficient patient care.
• Evaluates patient workload and redistributes to maintain equity.
• Gathers patient demographics, insurance info, and financial data.
• Initiates follow ups and coordinates deliveries with patient care team.
• Conducts staff orientation and training within enterprise pharmacy solutions.

Conocimientos

Leadership experience

Healthcare experience

Pharmacy knowledge

Patient communication

Customer service

Educación

Bachelor’s degree + leadership/healthcare/pharmacy experience

Associate degree + 3 years healthcare/pharmacy experience

High school diploma + 5 years healthcare/pharmacy experience

Herramientas

Pharmacy software systems

Descripción del empleo

Welcome! We’re excited you’re considering an opportunity with us! Below, you’ll find other important information about this position.

Coordinates, processes and manages manufacturer free drug program participants. Communicates with providers, office staff, & patients to obtain medication orders & financial information, to submit application to manufacturer programs. Communicates with system denials & revenue integrity teams to review claim edits & denials related to pharmaceuticals to ensure proper billing & payment. The successful candidate will ensure timely and accurate completion pharmacy patient access related needs. The candidate should have a strong knowledge of pharmacy and ability to communicate effectively while providing superb customer service.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

• 1. Bachelor’s degree AND One (1) year of leadership, healthcare, or pharmacy experience; OR Associates degree AND Three (3) year’s pharmacy, leadership, or healthcare experience; OR High school diploma or equivalent AND Five (5) year’s pharmacy, leadership, or healthcare experience.
• 2. Mustpossesscurrent licensure as required by state board where services will be provided: WV:Pharmacy Technician License or Trainee License through West Virginia Board of Pharmacy
• 3. Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or NationalHealthcareerAssociation (NHA)within 15 months of hire.

CORE DUTIES AND RESPONSIBILITIES:

• 1. Manages and monitors the workflow of manufacturer free drug programs to provide efficient patient care.
• 2. Routinely evaluates patient workload and provides recommendations for redistributing in efficient and equitable manner.
• 3. Gathers and documents patient demographics, insurance information, financial status, and other data as needed.
• 4. Initiates follow up communication, schedules deliveries as needed, and works closely with patient care team on treatment plans.
• 5. Conducts and documents staff departmental orientation and training. Manages new employee orientation in all enterprise pharmacy solutions service areas.
• 6. Drafts various correspondence letters, denial appeals, and referrals when necessary.
• 7. Develops and maintains strong working relationships with external, free drug programs, foundations, and vendors.
• 8. Performs medical benefit prior authorizations & benefit investigations for medications provided in clinics or infusion centers at various system facilities as requested.
• 9. Provides suggestions for staffing as needed based on planned and unplanned employee absences.
• 10. Manages & maintains all patient records in a timely and complete manner following department templates and guidelines.
• 11. Meets with DOPs of assigned hospitals on a routine basis to ensure high quality of service is being met.
• 12. Communicates with system denials team to resolve medication related denials, including pulling proof of medical necessity and coordinating written appeals from providers or clinical team.
• 13. Communicates with system revenue integrity team to ensure coding & billing quantities are accurate to our knowledge prior to billing in attempt to limit denials.
• 14. Manages & maintains current state and national registration/certifications.
• 15. Performs in a manner that promotes the work of the pharmacy patient access team and manages expansion of services at assigned sites as needed.
• 16. Extracts clinical notes, labs, and other scanned media in patient’s electronic medical record as necessary to complete assigned tasks.
• 17. Participates in division meetings with manager.
• 18. Consistently ensures that department and hospital policies and procedures are followed and updated as necessary.
• 19. Demonstrates the knowledge and skills necessary to communicate with patients, providers, & payers.

PHYSICAL REQUIREMENTS:

• 1. While performing the duties of this position, the employee is required to sit for long periods of time.
• 2. Dexterity required to finger, handle, and reach.

SKILLS AND ABILITIES:

• 1. Must possess a high level of interpersonal skills and poise.
• 2. Excellent verbal, written and decision making skills.
• 3. Knowledge of drugs, drugs dosing, indications, and proper administration preferred.
• 4. Must be polite and respectful when communicating with staff, physicians, patients and families. Must approach interpersonal relations in a positive manner.

Additional Job Description:

Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 249 SYSTEM Pharmacy Business Operations Address: 781 Chestnut Ridge Road Morgantown West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

The West Virginia University Health System is a West Virginia-based academic health system that provides the full continuum of healthcare services at 30 hospitals in West Virginia, Pennsylvania, Ohio, and Maryland. With more than 47,000 employees, of which 7,200 are providers, and $10 billion in total operating revenues, the WVU Health System is anchored by an 890-bed academic medical center and the 150-bed WVU Medicine Golisano Children’s Hospital in Morgantown, West Virginia. Together, the Health System’s hospitals, clinics, and specialty programs provide a comprehensive continuum of care, ranging from community-based primary and specialty services to highly complex, quaternary care and post-acute care.