Ambulatory Medication Access Coordinator (Specialty Pharmacy), Full-Time, Days

Ambulatory Medication Access Coordinator

Be a part of a world-class academic healthcare system at UChicago Medicine as an Ambulatory Medication Access Coordinator in the Specialty Pharmacy. In this role you will be responsible for handling inbound and outbound phone calls, conducting and completing necessary third party (insurance) prior authorization requests and associated services related to high-cost medications, maximizing efficiency for patients and clinic staff.

Eligible for a Sign-On Bonus up to $3,000

In this role, the Ambulatory Medication Access Coordinator, or AMAC, performs necessary functions to ensure optimal reimbursement for high cost, take home medications for patients receiving care in UCMC Ambulatory Clinics. Other areas of responsibility include handling inbound and outbound phone calls, pre-screening patients for viable payment sources, managing reimbursement issues associated with high-cost, take-home medications, identifying opportunities for improving reimbursement from payers, and completing necessary paperwork for prior authorizations.

Essential Job Functions

• Improve patient service experience and maximize UCMC pharmacy revenue through provision of prior authorization services on behalf of clinics for select high-cost medications.
• Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete prior authorization forms, negotiate authorization status with insurers, track status of prescription approval and when necessary, alert clinical pharmacists of denials or nonresponse.
• Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance.
• Enter patient information on tracking forms and in computer software.
• Expedite clinic workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, and clinic staff.
• Provide exemplary customer service to outpatients across UCMC, including handling inbound and outbound phone calls.
• Observe and understand prescribing trends within UCMC Ambulatory Clinics to identify areas for improved specialty pharmacy contracting.
• Assist with development and implementation of policies and procedures to ensure reimbursement of high-cost medications.
• Performs other duties as requested by leadership.

Required Qualifications

• Associate's or Bachelor's degree
• Current or Eligibility for Illinois Pharmacy Technician licensure
• 3 to 5 years of pharmacy technician experience in a retail pharmacy (exceptional aptitude or knowledge may be considered in lieu of experience.)
• Knowledge of and ability to use computers and a variety of computer programs including word processing, database management and spreadsheets
• Strong oral and written communications skills
• Ability to effectively manage conflicts and resolve problems
• Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction
• Ability to function effectively in a fast-paced and changing environment with multiple priorities
• Knowledge of and ability to perform insurance carrier/managed care review

Preferred Qualifications

• Knowledge of medication reimbursement preferred
• Knowledge of healthcare/prescription insurance billing, prior authorization, coding preferred

Position Details

• Job Type/FTE: Full-Time (1.0 FTE)
• Shift: Days
• Work Location: Hyde Park
• Unit/Department: Specialty Pharmacy
• CBA Code: Non-Union

In this role, we anticipate that you will be scheduled to work 8-hour shifts, day shift approximately between the hours of 7am-5:30pm and will not be scheduled for on-call shifts. We anticipate you will be scheduled to work a remote-hybrid schedule, working onsite 1 week every 3-5 weeks. The days of the week that you are scheduled will be Monday-Friday, and no weekends. This is subject to change.