Key Responsibilities
1. Medication Adherence & Quality Measures
- Monitor and track patient adherence to medications tied to NCQA measures (e.g., statins, diabetes, hypertension)
- Conduct outreach to patients to improve adherence and close care gaps
- Document and support quality metric performance initiatives
2. Prior Authorization Support
- Assist with prior authorizations during coverage gaps or high-volume periods
- Ensure timely submission and follow-up with payers
- Reduce delays in medication access and therapy initiation
3. Patient Assistance & Access Programs
- Enroll and support patients in internal medication assistance programs (MAP) and manufacturer programs
- Collect, verify, and maintain required documentation
- Help reduce financial barriers to medication access
4. Internal Prescription Capture
- Promote use of internal pharmacy services
- Coordinate prescription transfers, refills, and medication synchronization
- Address patient barriers related to cost, access, and convenience
5. Support of Clinical Pharmacist Services
- Perform operational tasks to allow pharmacists to focus on:
- Hypertension management
- Diabetes/A1C optimization
- High-risk patient interventions
- Support initiatives tied to triple-weighted quality measures
6. Data Tracking & Reporting
- Track and document:
- Medication adherence metrics
- Prior authorization outcomes
- Patient assistance enrollment
- Prescription capture rates
- Assist in reporting for quality programs and performance improvement.
Qualifications:
Education
- High school diploma or equivalent required
- Pharmacy Technician Certification (CPhT or equivalent) required
Experience
- Minimum 2 years of pharmacy technician experience preferred
- Experience in one or more of the following strongly preferred:
- Ambulatory care or clinical pharmacy
- Specialty pharmacy
- Medication assistance programs
- Prior authorization workflows
Skills & Competencies
- Strong understanding of medication adherence and chronic disease management
- Knowledge of insurance processes, including Medicare Advantage and commercial plans
- Excellent communication and patient engagement skills
- Ability to manage multiple workflows and prioritize tasks
- Detail-oriented with strong documentation skills