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…benefits package, competitive pay, flexibility, paid on the job training, professional development, and inspire you to be bold, yet accountable. We value our employee’s hard work and…
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Mazzoni Center

Medication Access Coordinator

Philadelphia, PA, United States

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Job details

Education: High school diploma
Posting language: English

Original job description

Job Summary: The Medication Access Coordinator supports medication access, pharmacy-related operations, and Mazzoni Center’s 340B Drug Pricing Program, with a primary focus on long acting injectable medications (LAIs) for PrEP and HIV treatment. The position is responsible for coordinating medication prior authorizations, setting up office administered medication deliveries from pharmacies, supporting patients and clinical teams in resolving medication access barriers, and assisting with 340B inventory management, reconciliation, and auditing activities. Working collaboratively with the clinical pharmacist, medical providers, nursing, clinical operations, Finance, and external pharmacy partners, Mazzoni Center’s Medication Access Coordinator helps ensure timely access to prescribed medications, accurate medication inventory, and effective pharmacy-related workflows. The position also supports monitoring and quality improvement activities designed to reduce medication authorization denials, prevent delays in treatment, and maintain the integrity of 340B inventory and purchasing processes.

Key Responsibilities:

Long-Acting Injectable Medication Coordination
Assist the clinical pharmacist with office-administered medication management, primarily LAIs for PrEP and HIV treatment, including completing prior authorizations, contacting specialty pharmacies to process prescriptions and deliver medication in time for scheduled appointments, and managing clinic inventory.
Verify medical versus pharmacy benefit coverage and payer requirements for medication acquisition and fulfillment.
Maintain shared tracking of upcoming injection appointments, authorization status and expiration dates, medication deliveries, and unresolved access barriers.
Coordinate with scheduling and case management staff when appointments change or are missed, and promptly escalate potential treatment interruptions to the clinical pharmacist or prescribing provider.

Medication Prior Authorizations and Access

Coordinate and submit medication prior authorizations for Medicaid, Medicare, commercial insurance, and other third-party payers.
Review payer requirements and obtain necessary clinical documentation, laboratory results, diagnosis information, treatment history, and other supporting information required for authorization.
Complete prior authorization requests through electronic platforms, payer portals, telephone, fax, and other required methods.
Monitor pending prior authorizations and proactively follow up with payers to facilitate timely determinations.
Coordinate denied authorizations and appeals, including gathering additional clinical documentation and communicating payer requirements to providers.
Coordinate with providers, patients, pharmacies, specialty pharmacies, and insurance plans to resolve medication access issues.
Identify common reasons for medication denials and collaborate with clinical teams to improve documentation and authorization workflows.
Track authorization expiration dates and coordinate renewals to minimize interruptions in medication therapy.
Assist clinical teams with identifying covered or formulary alternatives when prescribed medications are not covered.
Maintain accurate documentation of authorization requests, approvals, denials, appeals, and outcomes within appropriate organizational systems.
Assist clinical pharmacist with office-administered medication management – completing prior authorizations, contacting specialty pharmacies to process scripts and deliver medication in time for scheduled appointments, managing clinic inventory.

Medication and Patient Assistance

Assist patients and clinical teams with navigating medication coverage and access barriers.
Support enrollment in manufacturer patient assistance programs, copay assistance programs,and other medication affordability resources when appropriate.
Coordinate with specialty and retail pharmacies regarding prescription status, coverage issues, medication availability, and fulfillment.
Assist patients in understanding next steps related to medication authorization and access.
Support continuity of medication therapy by proactively identifying and resolving administrative barriers that may delay treatment.

340B Program and Pharmacy Operations

Provide operational support for the organization’s 340B Drug Pricing Program in accordance with organizational policies and applicable program requirements.
Assist with medication and vaccination purchasing, receiving, inventory tracking, and reconciliation processes, including appropriate separation and tracking of 340B and non340B medication inventory utilizing FlexScan.
Perform routine reconciliation of medication purchasing, administration, dispensing, and inventory records.
Identify inventory discrepancies and work with appropriate staff and pharmacy partners to investigate and resolve variances.
Assist with routine internal audits of 340B transactions, purchasing records, and medication inventory, including review and maintenance of 340B medication destruction logs for expired, damaged, or otherwise unusable medications.
Support preparation for HRSA, manufacturer, and other external 340B audits by gathering organizing, and validating requested documentation.
Identify and promptly escalate potential 340B compliance concerns or inventory discrepancies to appropriate leadership.
Collaborate with Clinical Operations, Finance, Compliance, and pharmacy partners to maintain accurate and compliant medication inventory processes.

Other Responsibilities:

Demonstrate ability to embody and uphold Mazzoni Center’s core values: Respect for People, Patient-Focused, Inclusivity, and Integrity in all aspects of work.
Protect patient information and records at all times in compliance with agency confidentiality policies, Pennsylvania Act 148 and HIPAA.
Actively participate in weekly supervision meetings.
Participate in departmental and agency meetings, staff in-services, and external trainings as required.
Maintain organized documentation of data processes and reporting requirements.
Perform other duties as assigned.

Education, Skills, and Experience

High school diploma plus at least three years’ experience in pharmacy operations or insurance authorization work is required.
Completion of an accredited Pharmacy Technician training program preferred.
Certified Pharmacy Technician (CPhT) certification preferred.
Must meet all applicable Pennsylvania requirements for pharmacy technicians.
Minimum of two years of pharmacy technician, pharmacy operations, insurance company or specialty pharmacy medication access, or related healthcare experience preferred.
Experience coordinating specialty pharmacy services or access to injectable medications preferred.
Experience completing medication prior authorizations.
Experience working in an FQHC, community health center, ambulatory care, specialty pharmacy, or similar healthcare environment preferred.
Experience supporting 340B pharmacy operations, medication inventory, or pharmacy auditing preferred.
Experience with electronic health records (e.g., AthenaHealth) preferred.
Strong attention to detail and commitment to data accuracy.
Excellent organizational, analytical, and problem-solving skills.
Strong commitment to Mazzoni Center’s mission.

Clearances

Background checks are required, including but not limited to: Criminal Background Clearance, Child Abuse Clearance, and FBI Clearance. Physical Requirements
This position involves primarily sedentary work, requiring the ability to sit for extended
periods of time and only occasional standing and/or walking.
Occasional lifting/carrying of files and documents.
The ability to communicate using written and spoken words.
The ability to lift objects up to 25 pounds.
Must have all necessary vaccinations/proof of immunization.

This job description is a general digest of the essential and expected functions and duties of the position; it is not designed to explicitly list every activity, duty or responsibility that is or may be required of the employee while performing the job. Duties, responsibilities, and activities related to or essential to accomplish the key responsibilities and tasks listed in this job description may be assigned at any time

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Jobs in the United States