Pharmacy Access Rep IV

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.

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ESSENTIAL FUNCTIONS

• Assesses and anticipates daily operations to ensure optimal support staff allocation, proactively managing cross-coverage to maintain seamless functionality while ensuring all tasks and patients are cared for appropriately daily.
• Acts as a pivotal resource and subject matter expert for the pharmacy team, providing advanced guidance on tasks requiring specialized expertise and training.
• Leads the development, implementation, and ongoing refinement of critical documentation, policies, and standard operating procedures, ensuring they remain aligned with best practices through regular reviews and updates.
• Partners with supervisors to spearhead high-impact initiatives, offering leadership and strategic direction on projects to enhance patient safety, improve operational efficiency, and drive cost-effective outcomes.
• Drives the evaluation and integration of innovative workflows and procedures within their practice area to elevate service delivery and streamline processes.
• Provides expert support in resolving complex patient issues, including high-level complaints and delivery challenges, ensuring swift and effective resolution.
• Leads the development and maintenance of training and competency assessments within their area of practice. 
• In collaboration with the PAR leadership, assists in the structured onboarding and continuous professional development of newly hired team members.
• Serves as a mentor and leader, offering guidance, support, and leadership to all support staff, fostering professional growth and development.
• Collaborates with the pharmacy team members to identify and resolve patient care challenges, ensuring a streamlined and efficient approach to patient services.
• Contributes to pharmacy department initiatives, leading projects by setting clear objectives, establishing deadlines, monitoring progress, and evaluating outcomes to drive continuous improvement.
• Ensures effective communication across the team, aligning all members with project goals and providing timely updates to pharmacy leadership.
• Participates in the recruitment and interviewing process for PAR positions, partnering with PAR leadership to select top talent and build a strong team.
• Achieves high patient and provider satisfaction results, remaining professional, courteous, and diligent in all interactions with staff and patients/families.
• Contributes to quality improvement initiatives and reports errors through the hospital reporting system.
• Contributes to the overall integrity and efficiency of operational processes by assisting in audits that require timely completion of required patient documentation.
• Supports these audit processes and provides feedback on areas of improvement for future occurrences.
• Reinforces monitoring and compliance required by accrediting bodies. 
• Coordinates medication and supplies preparation with pharmacy staff to ensure timely delivery.
• Troubleshoots insurance issues with pharmacists, physicians, and staff to prevent treatment interruptions. Follows up with patients to ensure safe and effective medication use.
• Documents problems with the medication and triages issues with the pharmacist when appropriate. 
• Coordinates medication ordering with the inventory manager for special orders or low-volume medications.
• Tracks changes in prescribing trends and coordinates with the inventory manager if changes in stock on hand are needed.
• Makes scheduled calls to patients 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. Answers incoming calls in a timely manner. 
• Monitors and reconciles patient charge accounts once a month. 
• Serves as an expert 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 who 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, and to present PAP options to the patient/family when there are multiple options.
• With permission, enrolls patients in PAPs using necessary information, follows up to determine the application status, and ensures proper documentation of this process.
• Submits all required documentation to the PAP throughout the duration of treatment to verify that payment for each prescription refill is still active.
• Understands and manages the payment process specific to each PAP and ensures that payments are properly accounted for the correct patient and 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 clinic staff about financial assistance resources, including PAPs, grants, foundations, manufacture coupons, and social work.
• Collaborates with social services and case management on patient assistance.
• Serves as an expert on the current policies of the most common payors for the relevant administered drugs that require prior authorization (PA) and works with the prior authorization team, office staff nurses, and other patient care staff to ensure 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 location(s) to improve patient experience, ensure compliance, and prevent interruptions or delays in treatment.

Other duties as assigned.

EDUCATION AND EXPERIENCE

• Associate’s degrees in medical, Secretarial, or related field and five years of relevant experience required.
• or equivalent combination of education and experience.

KNOWLEGE AND ABILITY

• Capable of working independently with minimum supervision required.
• Strong communication skills, problem-solving abilities, and a professional presentation required.
• Demonstrated excellent customer relations skills required.
• Ability to multi-task, managing various details with accuracy, working under pressure and maintaining a professional attitude required.

LICENSES AND CERTIFICATIONS

• ASHP accredited training program upon hire preferred
• Certification from a nationally accredited pharmacy technician certification program (Currently PTCB) upon hire preferred

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture 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 characteristic protected by federal, state, or local law (Protected Classes). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates for all persons consistent with our values and based on applicable law.