JOB TITLE: Medication Access Specialist
Department: Nebraska Hematology-Oncology Pharmacy
Reports to: Pharmacist-in-Charge
JOB SUMMARY:
The Medication Access Specialist supports patients through the medication access and coordination process while assisting with daily pharmacy operations under the supervision of a licensed pharmacist. This role requires Pharmacy Technician certification and is responsible for managing prior authorizations, benefits investigations, appeals, and financial assistance programs to help reduce barriers to treatment and improve timely access to prescribed therapies.
In addition to reimbursement and patient support functions, this position performs Pharmacy Technician duties including prescription processing, medication preparation, inventory management, refill coordination, and support of pharmacy workflow. The Medication Access Specialist works collaboratively with providers, pharmacists, patients, payers, and external pharmacies to facilitate communication regarding medication access, scheduling, and treatment coordination.
This role also assists with gathering and updating medication history information for pharmacists and provider review, preparing documentation, and identifying and communicating barriers to medication access. The position requires strong knowledge of insurance processes, pharmacy operations, medication coordination, and patient-centered service while operating within the scope of Pharmacy Technician responsibilities under Nebraska law.
DUTIES / RESPONSIBILITIES:
Access & Reimbursement
- Submit and manage prior authorizations and appeals for medications
- Conduct benefits investigations and verify insurance coverage
- Determine and communicate patient financial responsibility
- Secure financial assistance (copay programs, grants, foundations, free drug programs)
- Monitor and resolve delays in medication access, including coordination with external specialty pharmacies
- Support billing-related activities including charge review, audits, and payment coordination
Clinical & Patient Support
- Serve as a liaison between patients, families, providers, and staff
- Identify and escalate barriers to care impacting treatment access
- Educate patients and families on available assistance programs and resources
- Coordinate with care teams (oncology, palliative, behavioral health) to align medication plans
- Maintain accurate medication lists and support medication reconciliation
- Prepare documentation and organize information for pharmacist and provider review
- Facilitate referrals to community resources and support programs
Pharmacy Operations (Technician Functions)
- Process prescriptions, including data entry and preparation for pharmacist verification
- Assist in medication dispensing, packaging, and distribution
- Maintain pharmacy inventory, including ordering, stocking, and removing outdated medications
- Handle refill requests and manage communication queues (calls, faxes, electronic messages)
- Maintain records of prescriptions and physician orders
- Ensure compliance with safety protocols, infection control, and hazardous drug handling
- Support daily pharmacy workflow, including customer service and operational tasks
Administrative & Compliance
- Maintain accurate, complete, and timely documentation across all systems
- Ensure compliance with HIPAA and patient confidentiality standards
- Participate in audits, inspections, and quality improvement initiatives
- Assist with reporting, data collection, and performance tracking
- Participate in required meetings, committees, and training programs
- Adhere to all federal, state, and local regulations, as well as internal policies
- Perform all other duties as assigned
QUALIFICATIONS:
Required
- High school diploma or GED
- Pharmacy Technician certification (PTCB or equivalent)
- 3-4 years' experience (full time) as a Pharmacy Technician
- Licensed with Nebraska Department of Health and Human Services
- Experience with insurance processes, prior authorizations, or pharmacy operations
- Strong communication, organization, and problem-solving skills
Preferred
- Experience in oncology, specialty pharmacy, or complex medication therapies
- Experience with financial assistance programs (grants, copay, manufacturer programs)
- Knowledge of Medicare, Medicaid, and commercial payer requirements
- Experience in a medical or clinic setting
PERFORMANCE REQUIREMENTS:
- Ability to communicate effectively with patients, providers, and staff
- Strong critical thinking and independent problem-solving skills
- Ability to manage multiple priorities and meet deadlines
- Ability to maintain professionalism in high-stress situations
- Strong attention to detail and accuracy in documentation
- Ability to work both independently and collaboratively
SUPERVISION & LIMITATIONS
- Operates under the supervision of licensed pharmacists
- Does not perform final prescription verification or independent clinical decision-making
- All clinical evaluations and therapy decisions are reviewed and approved by a pharmacist
WORKING CONDITIONS
- Office and pharmacy environment with frequent interaction with patients and third parties
- May involve handling sensitive situations and working with patients under stress
- Exposure to hazardous medications and communicable diseases
- Requires standing, walking, and occasional lifting (up to 50 lbs)
