Medication Access Technician

As a patient-centered organization, UCSF Medical Center exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership and respect. UCSF Medical Center seeks faculty and staff that are committed to the values of professionalism, respect, integrity, diversity and excellence that are integral to our mission

Under the supervision of the Medication Access Manager and guided by the policies and procedures of the Ambulatory and Outpatient Pharmacy Services, the Pharmacy Medication Support Specialist (MSS) facilitates prescription prior authorization (PA) and refill requests This role involves obtaining, preparing and submitting the necessary forms  for insurance authorizations, requesting information from insurance companies regarding possible alternative therapies, and providing patients with timely communications regarding the status of the PA.  In addition, this position is also responsible in facilitating medication refills requests. Using a refill protocol, the MSS evaluates refill requests for adherence to the refill protocol criteria which includes reviewing a patient’s medical record in APeX and contacting a patient for needed information. The MSS also performs medication benefits investigations and explores financial assistance options where applicable, to ensure patients have access to the medication they need, acting as the primary contact for all medication authorization and refill requests.

Responsibilities

DUTIES & ESSENTIAL JOB FUNCTIONS

%  

of time

Essential Function (Yes/No)

Key Responsibilities

(To be completed by Supervisor)

45

YES

Prior Authorization (PA) and Financial Assistance Facilitation

• Under the oversight of pharmacists, drives the Prior Authorization (PA) process to completion and resolves any related issues.
• Performs medication benefits investigation and accurately submits prior authorizations to insurance manually, electronically, or telephonically as necessary
• Notifies the patient and documents the status of the PA and financial assistance in APeX
• Follows up with health insurance payors that don’t respond to submitted PA requests
• Works with pharmacists or providers for any denials and appeals
• Evaluates patient assistance program opportunities if necessary

45

YES

Refill Authorization