The Ambulatory Medication Access Coordinator (AMAC) will coordinate access to specialty medications for TMC patients, ambulatory providers, and pharmacy team. The AMAC will provide high quality care by ensuring optimal access and reimbursement for high cost, take home medications for patients receiving care in TMC ambulatory clinics. This position will conduct benefit investigations, complete necessary third party (insurance) prior authorization requests and associated services related to high cost medications, maximizing efficiency for patients and clinic staff. The AMAC will pre-screen patients for viable payment sources, manage reimbursement issues associated with high cost take-home medications, identify opportunities for improving reimbursement from payers, compile reports for contract optimization, complete the necessary paperwork for prior authorizations, conduct retrospective utilization reviews on cases of payment denials or insufficient reimbursement, and refer to pharmaceutical assistance programs as appropriate. The AMAC will serve as a liaison to other TMC pharmacy services.
Completion of a Bachelor degree program in a Healthcare related field or an equivalent combination of education and experience
3 to 5 years of health care and/or specialty pharmacy and/or insurance prior authorization experience
Exceptional aptitude or knowledge may be considered in lieu of experience
Registered Pharmacy Technician within Missouri upon employment
Must obtain nationally recognized certification within 6 months of hire; PTCB or equivalent.
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
Internal Number: 16182-124
About Truman Medical Centers
Truman Medical Centers is a 600-bed, non-for-profit health system. Comprised of two campuses, Truman Medical Centers is the largest and most comprehensive safety net healthcare provider in the Jackson County / Kansas City metro area. Truman Medical Centers also serves as the primary teaching institution for the University of Missouri – Kansas City (UMKC) Schools of Medicine, Nursing, Dentistry, and Pharmacy.
Truman Medical Centers Heath Sciences District is located in downtown Kansas City, Missouri. The Health Sciences District represents a robust academic community, leading the forefront of biomedical research and entrepreneurship, employing cutting edge and award-winning technology, and delivering state-of-the-art evidence-based health care, with outstanding service excellence. Partnered with UMKC and Children’s Mercy Hospital, Truman Medical Centers serves as the cornerstone in educating the next generation of healthcare practitioners. Specializing in Emergency Medicine, Critical Care, with a fully-integrated Cath Lab, Truman Medical Centers is delivering the highest quality medical care for our patients with compassion, empathy, and unparalleled dedication to service.
Truman Medical Centers Lakewood is located between Kansas City and Lee’s Summit, Missouri, offering residents of Eastern Jackson County access to a modern community hospital with a continuum of outpatient services designed to meet the needs of families. Truman Medical Centers Lakewood specializes in high-risk maternal and child care, and serves as one of the few Kansas City metro area institutions accredited by The Joint Commission in Orthopedics and Palliative Care.
Highest quality, innovation, teamwork, and attention to detail serve as pillars for the foundation of our focus – OUR patients. At Truman Medical Centers, we Bring It. We handle the tough cases. Join us in our vision of leading the way to a healthy community.