Job Description

Be a part of a world-class academic healthcare system at UChicago Medicine (UCM) as an Ambulatory Medication Access Coordinator for the Outpatient Pharmacy team. In this role you will be responsible for assistance related to high-cost medications administered in our infusion centers, maximizing efficiency for patients and clinic staff. UChicago Medicine Duchossois Center for Advanced Medicine - Hyde Park, also known as DCAM, is our flagship outpatient facility and is home to dozens of primary and specialty clinics as well as a pharmacy.

In this role, the Ambulatory Medication Access Coordinator, or AMAC, performs necessary functions to ensure optimal reimbursement for high cost, medications for patients receiving care in UCM ambulatory clinics and infusion centers. Other areas of responsibility include pre-screening patients for viable payment sources, managing reimbursement issues associated with high-cost medications, identifying opportunities for improving reimbursement from payers, compiling reports for contract optimization, completing the necessary paperwork for prior authorizations, and conducting retrospective utilization reviews on cases of payment denials or insufficient reimbursement. This specific role will focus on enrolling patients into assistance programs to reduce costs for chemotherapy and biologic infusion and injections. 

Essential Job Functions:

• Identify and enroll infusion center patients into foundation and copay card programs. 
• Collaborate with pharmacists and doctors for free drug program enrollment.  
• Coordinate ongoing shipments of free drug and retail-dispensed products for the main campus and off-site infusion centers.
• Manage patient-specific inventory in Hyde Park campus, including de-boxing and documentation of shipments.
• Occasionally 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.
• Enter patient information on forms and in computer software.
• Expedite clinic workflow and enhance patient care by preventing therapy interruptions due to insurance or program issues in conjunction with pharmacists, physicians, and clinic staff.
• Provide exemplary customer service to outpatients across UCM.
• Assist with the development and implementation of policies and procedures to ensure reimbursement of high-cost medications.

Required Qualifications: 

• Associate or Bachelor’s degree
• Current or Eligibility for Illinois Pharmacy Technician Licensure
• 3 to 5 years of experience in a retail pharmacy or similar revenue cycle role (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 

Position Details:

• Job Type/FTE: Full-Time (1.0 FTE)
• Shift: Rotate – 8-hour shift
• Unit/Department: Outpatient Pharmacy  
• CBA Code: Non-Union

In this role, we anticipate that you will be scheduled to work the day shift, you will approximately work either 7:30-4pm or 8am-4:30pm and will not be scheduled for on-call shifts.  We anticipate you will be scheduled to work mostly remote with the current schedule being 2 weeks remote, 1 week on site at the Hyde Park campus. On-site days will also be required for PTO coverage and training. The days of the week that you are scheduled will be Monday-Friday, and no weekends.