Pharmacy Access Specialist at SSM Health

It's more than a career, it's a calling

WI-SSM Health West Beltline

Regular

Job Highlights:

• Sign-on Bonus Eligible – $2,000 (Sign-on bonuses are for external qualified candidates.  Internal candidates – check with your recruiter to see what options are available for you)
• Department: Dean Medical Group
• Schedule: Full Time, Day Shift, Must complete 90-day probationary period onsite before moving to hybrid/work from home.
• Starting Pay: 23.86 minimum (Offers are based on years of experience and equity for this role.)
• Shift Differentials: N/A
• Location: Dean Medical Group, West Beltline Wisconsin

Job Summary:

Increase patient access and adherence to medically necessary pharmaceuticals by managing patient’s insurance benefits and utilizing established patient assistance programs. Provides value-added services by developing client-based relationships with clinical staff and patients, presenting pharmacy service options through customized financial analysis, and facilitating information gathering for program enrollment (patient assistance and indigent programs).

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Serves as the liaison between the medical staff, outpatient pharmacies, insurance providers and patients to improve communication and continuity of care.
• Review patient demographics, medication history, and insurance status to identify socioeconomic barriers, opportunities for intervention and eligibility for prescription assistance.
• Improves patient service experience through the provision of benefits investigations and conducting prior authorization services. Develops a thorough understanding of payer reimbursement and patterns for pharmacy and medical claims with third parties.
• Serves as primary ambulatory pharmacy resource to facilitate access to prescription and medical benefit medications. Including but not limited to; formulary/coverage issues, copay issues, patient assistance program eligibility, and other indigent programs.
• Coordinates services with appropriate departments and internal patient care team members regarding patients who have limited financial resources for paying for medications and facilitates medication access to support discharge preparations.
• Interacts with hospital and clinic employees, including but not limited to pharmacists, clinical staff, fiscal personnel, department managers, access services staff, coding staff, and billing assistants. External contacts include but are not limited to third party payers, manufacturers, prescription benefit management companies, external pharmacy personnel, and referring providers and their support staff.
• Reviews complex insurance situations in order to educate patients, providers, and clinic staff on how to follow appropriate next steps to get access to prescription and medical benefit information. 
• Performs other duties as assigned.

EDUCATION

• Bachelor's degree or equivalent years of experience and education

EXPERIENCE

• No experience required

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS 
 
State of Work Location: Illinois 

•     Pharmacy Technician, Registered - Illinois Department of Financial and Professional Regulation (IDFPR) 

     
State of Work Location: Missouri 

•     Pharmacy Technician - Missouri Division of Professional Registration 
•     Or 
•         MO Registration Application and Fingerprint Process Complete AT TIME OF HIRE - Missouri Division of Professional Registration 
•         And 
•         FUTURE - Pharmacy Technician, Registered within 6 months - Missouri Division of Professional Registration 

State of Work Location: Oklahoma, Wisconsin 

•     N/A

Work Shift:

Day Shift (United States of America)

Employee

7721840164 WRO Pharmacy Access

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SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity,pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.