What are the responsibilities and job description for the Medication Access Specialist - Pharmacy Prior Authorization Support - Family Practice Clinic - Hybrid position at Ochsner LSU Health Shreveport?
This job assists providers by ensuring patients' compliance with medications, lab monitoring, adherence to medication therapy, authorizing medication refills, maintaining accurate pharmacy preferences, identifying discrepancies or problems with medication history information, assisting patients with the medication authorization process, and assisting patients with overcoming barriers to accessing medications. Communicates with patients, families, caregivers, healthcare providers/practitioners, and pharmacy personnel to maintain accurate and complete medication history information while documenting the encounters within the electronic health record (EHR). Forwards any problems to a pharmacist, provider, or clinic staff to assist with resolution.
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 qualified individuals with disabilities to perform the essential duties.
This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company’s discretion.
Education
Required – High School Diploma or equivalent.
Work Experience
Required – 2 years of experience as a pharmacy technician, medical intake, or healthcare employee working with medications.
Preferred – Experience working with insurance to process medication authorizations, working with outpatient clinics and processing medication refill request, or experience with taking patient medication history.
Certifications
Required - Medication Therapy Management Certification obtained through the PTCB
OR
NHIA Reimbursement training
OR
Medication History Certification from the American Society of Health-System Pharmacists (ASHP) must be obtained within 6 months.
Knowledge Skills and Abilities (KSAs)
- Proficiency in using computers, software, and web-based applications.
- Knowledge of pharmaceutical mathematics.
- Effective verbal and written communication skills and ability to present information clearly and professionally.
- Ability to operate standard pharmacy and office equipment.
Job Duties
- Processes patient on-boarding.
- Coordinates with providers and patients to assess eligibility for financial support.
- Navigates the medication authorization process.
- Obtains and clarifies patients' home/chronic medication.
- Uses the EHR to input patients’ home/chronic medication lists.
- Communicates discrepancies identified via the medication history process with the pharmacist and makes clarifications with the patient and prescribers as needed.
- Collects patients’ prescription benefit information.
- Communicate and direct all questions or inquiries from patient or families that are outside the scope of taking the medication history to the appropriate caregivers or staff.
- Provides high quality customer service to patients, family members, and care team members.
- Documents all appropriate findings into the EHR for ease of collaboration amongst providers, support staff, and other refill clinic staff.
- Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.
- Performs other related duties as required.
The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.
Remains knowledgeable on current federal, state, and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations, and standards.
This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
Physical and Environmental 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.
Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.
Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk for exposure to communicable diseases.
Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.
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Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Maryland, New York, Washington, and Washington D.C.
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