Job Description
Under the supervision of the Assistant Director of Pharmacy, the Medication Assistance Program Coordinator will provide support to pharmacists, physicians, patients, clinical pharmacy practitioners /specialists and managers in all aspects of administering patient assistance programs. Maintains a working knowledge of safety net and other patient assistance programs and interviews patients to determine their potential qualification
Responsibilities
Demonstrates a working knowledge of patient assistance programs, including new programs, third-party billing (Medicare, Ohio Welfare, Part D), Co-Pay Assistance, Insurance verification
Serves as a resource person for billing problems (ICD-9, HCPCS), Part D and Medicaid MCO plan selection, Part D LIS
Collaborates with physicians, clinic staff, case managers, pharmacy staff and Social Service to identify potential patients for enrollment both inpatient and outpatient
Interviews patients to determine their potential qualification for patient assistance programs by reviewing health/prescription insurance and financial statu
Obtains clinical information from patient charts specific to program requirement
Communicates with patient assistance program representatives to enroll patient
Collaborates with physicians and clinic staff regarding additional documentation and signatures necessary for completion of enrollment form
Facilitates approval process with assistance program representative
Records patient specific drug supply shipment information and communicates with patient and health care professionals as necessary to facilitate patient care
Communicates with assistance program representatives, patients, physicians and other parties as necessary for maintenance of patients in assistance program
Maintains a list of current and potentially new patient
Serves as a resource person in planning, implementing and expanding access to patient assistance program
Maintains communication with The Christ Hospital Medicine Clinic for potential free medication or co-pay assistance. Communicates with TCHHN, Pulmonary, and Rheumatology offices to schedule delivery of free medication for their ambulatory procedure patients.
Assists in problem identification and problem resolution activities with other health professionals that occur whether short term (their shift) or long term (continuous quality improvement)
Provides patient assistance program, co-pay, foundation inservice / training to physicians, clinic and office staff as needed for new and/or changes to existing program
Completes activities to enable patients to receive specialty medication in a timely and affordable manner.
Adjudicates prescription claims as needed and works with payors for approval
Enrolls patients in co-pay assistance (co-pay card, foundation funding, manufacture provided assistance programs) as needed
Follows up with patients to schedule refills
Sets up appropriate medication delivery.
Prepares and provides to Director of Pharmacy Services report of drug expense avoidance as needed for each service. Performs other duties as deemed necessary by the Director of Pharmacy
As a representative of both The Christ Hospital and the Department of Pharmacy Services, promotes a positive image in all dealings with other hospital employees and hospital guest
Qualifications
KNOWLEDGE AND SKILLS:
Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.
EDUCATION:
Associate or Bachelor Degree with two years experience working directly with customers
YEARS OF EXPERIENCE:
REQUIRED SKILLS AND KNOWLEDGE:
Excellent communication and interview skills. Experience in managing financial and /or clinical information. Experience working with financial eligibility or third party programs. Experience working with data base computer software programs.
LICENSES & CERTIFICATIONS:
Pharmacy Technician Certification