Pharmacy Access Rep III – Community Pharmacy

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

120 Corporate Woods, Rochester, New York, United States of America, 14623

Opening

Worker Subtype:

Regular

Time Type

Full time

Scheduled Weekly Hours

40

Department

500160 Pharmacy SMH

Work Shift

UR - Day (United States of America)

Range

UR URCA 206 H

Compensation Range

$19.08 - $25.77

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities

GENERAL PURPOSE:

The Pharmacy Access Representative III (PAR) is responsible for the overall management of medication coordination and removal of barriers that prevent patients from receiving their medications. Duties will include communication with the prescriber’s office to acquire necessary information to submit prescriptions to the patient’s insurance for approval including prior authorization and helping enroll patients in financial assistance programs and arrange timely delivery of the medication. The PAR will link communication between the patient, pharmacist, insurance, and staff to ensure coordinated care.

The PAR will be assigned a set of patients to manage along with a pharmacist. Daily tasks are completed independently and prioritized based on the patient and pharmacist needs. Duties of this position require proper judgement, sensitivity, and strict adherence to Strong Memorial Hospital policy on confidentiality and the protection of Private Health Information. The PAR interacts with multiple individuals within the institution including, but not limited to, hospital and clinical employees at various levels including pharmacists, pharmacy technicians, medical/clinical staff, and central prior authorization staff. External interactions include third party payors, governmental peer review organizations, and referring physicians. To be successful, this individual must have excellent phone etiquette and be open to feedback to create strong collaborative work relationships.

Essential Functions

Pharmacy Coordination

• Coordinates medication and supplies preparation with pharmacy staff to ensure timely delivery. Troubleshoots insurance issues with pharmacists, physicians, and staff to prevent treatment interruptions.
• Follow-up with patients to ensure safe and effective medication use. Documents problems with the medication (i.e. delivery issues, side effects, adherence, difficulty with administration, etc.) and triages issues to the pharmacist when appropriate.
• Coordinates medication ordering with inventory manager for special order or low volume medications. Tracks changes in prescribing trends and coordinate with inventory manager if changes in stock on hand is needed.
• Makes scheduled calls to patient to bill prescriptions and set up deliveries. Facilitates adherence to medications by ensuring that patients receive prescribed medications in a timely manner.
• Provides excellent customer service through the Pharmacy Call Center. Triages patient calls to appropriate party. Answer incoming calls in a timely manner.
• Monitors and reconciles patient charge accounts once a month.
  
  

Financial Assistance Management

• Maintains expertise on all potential patient assistance programs (PAP), grants, foundations, and coupons relevant to the high-cost drugs prescribed in their assigned area(s).
• Analyzes patients that are receiving high-cost medications for potential participation in PAPs, and identifies the best option(s) for the patient given their overall circumstances (insurance, disease state, income, etc). Coordinates with the patient and/or family to obtain necessary information including income information and other personal details, as well as to present PAP options to the patient/family when there are multiple options.
• Enrolls patients in PAPs using the needed permission and information, follow-up to determine the status of the application, and ensure proper documentation of this process. Submits all required documentation to the PAP throughout the duration of treatment to verify payment for each prescription refill is still active. Understands and manages the payment process specific to each PAP, and assures that payments are properly accounted for the correct patient and correct patient encounter.
• Meets or discusses with the patient and/or family the status of PAP eligibility on an as-needed basis if coverage changes during treatment duration.
• Serves as a subject matter expert available to patients, providers and other staff about financial assistance resources, including PAPs, grants, foundations, manufacture coupons, and social work.
• Collaborates with social services and case management on patient assistance.
  
  

Compliance and Quality

• Remains professional, courteous and diligent in all interactions with staff and patients/families.
• Obtains high patient and provider satisfaction results.
• Reports errors through hospital error reporting system (RL solutions) and contribute to quality improvement initiatives.
• Assists with prescription audits and ensure timely completion of required patient documentation.
• Assists with training of new team members in designated clinical area.
• Performs other related duties as required, including work relating to the Intake Pharmacy Access Representative
  
  

Prior Authorization Management

• Maintains expertise of the current policies of the most common payors for the relevant administered drugs that require prior authorization (PA), and will be responsible for working with the prior authorization coordinators, office staff nurses and other patient care staff to assure that all required elements of the policy are applicable in advance of requesting PA.
• Initiates, documents, and tracks all prior authorization on behalf of the areas to improve patient experience, ensure compliance, and prevent interruptions or delays in treatment.
  
  

Qualifications

• At least 18 years of age at the time of application required.
• Associate’s degrees in Medical, Secretarial, or related field or equivalent combination of education and experience required.
• Minimum of four years of relevant experience or equivalent combination of education and experience required.
• Capable of working independently with minimum supervision required.
• Exhibit strong communication skills, problem-solving abilities, and a professional presentation required.
• Demonstrate customer relations skills required.
• Individual must be able to multi-task, manage many details with accuracy, work under pressure, and maintain professional attitude required.
• Complete ASHP accredited training program or equivalent experience as a pharmacy technician, or Certification from a nationally accredited pharmacy technician certification program (Currently PTCB) and maintain ongoing education requirements preferred.
  
  

EOE Minorities / Females / Protected Veterans / Disabled

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.