DescriptionPOSITION OVERVIEW
We are seeking a strategic, hands-on medication access pharmacy leader to own medication access services for our Harbor Health infusion, primary care, and specialty clinics. As the Medication Access Manager, you will proactively identify and resolve operational risks, workflow inefficiencies, and medication access barriers that impact patients and providers.
POSITION DUTIES & RESPONSIBILITIES
Infusion Clinic (40%)
- Review the daily schedule for authorization, insurance, financial, medication, or other issues that could affect treatment.
- Discuss manufacturer copay assistance with eligible patients, obtain consent, and complete enrollment documentation.
- Perform drug-administration reconciliation for self-pay and specialty-pharmacy claims to help prevent duplicate billing.
- Review potential missing claims and maintain documentation for the revenue cycle management team to investigate and correct.
- Order medications for upcoming treatments and maintain the inventory spreadsheet used by the practice manager when reviewing invoices and approving payments.
- Collaborate with our pharmaceutical distributor, Group Purchasing Organization (GPO), and pharmaceutical account managers regarding product availability, contracting, pricing/rebate considerations, manufacturer updates, and other changes that may affect the clinic.
Multi-Specialty Clinic (40%)
- Support specialists including cardiology, endocrinology, and rheumatology with high complexity prior authorizations.
- Build workflows and manage programs that support improved medication access for primary care and specialty programs.
- Identify and sign up members for patient assistance programs.
- Own first pass prior authorization (PA) approval rates and time to treatment.
- Partner with clinic operations to improve medication access.
- Evaluate medication access and pharmacy support operations to identify opportunities for enhanced efficiencies, productivity, and service quality.
Cross-Functional Collaboration & Strategy (20%)
- Serve as the primary liaison between internal teams and external stakeholders, maintaining consistent and transparent communication to foster strong, aligned partnerships.
- Partner cross-functionally with product, clinical, network, actuarial and other stakeholders to ensure integrated care approaches.
- Contribute to organizational initiatives, including participation on clinical committees, providing education, quality review, and other mission-aligned activities.
DESIRED PROFESSIONAL SKILLS & EXPERIENCE
Required
- Bachelor's degree required; four (4) years of relevant experience may be considered in lieu of a degree.
- Active CPhT certification through either PTCB or NHA obtained within 12 months of hire.
- Minimum 3 years of pharmacy experience working with healthcare providers on strategic and operational initiatives.
- Strong teamwork capabilities while maintaining ability to function independently.
- Sound judgment, flexibility to shift priorities, and commitment to confidentiality.
Preferred
- Experience working with electronic medical record (EMR) systems to support clinical and operational workflows, specifically athenahealth.
- Experience working within commercial health plans and/or innovative health insurers (e.g., startup or growth-stage plans).
WHAT WE OFFER
- Competitive base salary and benefits package
- Comprehensive medical, dental, and vision benefits
- 401(k)
- Generous PTO and paid holidays
- Collaborative and dynamic work environment within an innovative, integrated payvider model
- Professional development and growth opportunities
- A transparent and unique culture focused on member-centered care
