General Summary
The Medication Access Manager oversees the pharmacy prior authorization and medication access program, ensuring timely and efficient access to medications for patients. This role manages daily operations of the prior authorization team while developing standardized workflows, performance metrics, and process improvements to optimize medication access.
Key Responsibilities:
- Collaborates with pharmacists, prescribers, clinical teams, and payers to streamline authorization processes, reduce barriers to therapy, and support ambulatory and specialty pharmacy services. Analyzes program performance and implements solutions to improve operational efficiency and patient access.
- Provides leadership and operational oversight of the pharmacy prior authorization and medication access program, ensuring timely, accurate, and efficient processing of medication prior authorizations. Develops, implements, and continuously improves standardized workflows, policies, and procedures to optimize medication access and operational efficiency.
- Collects, analyzes, and reports program metrics including prior authorization turnaround times, approval and denial trends, and workflow productivity to evaluate program execution and inform operational improvements.
- Identifies opportunities to improve medication access processes, reduce payer-related barriers, and support prescription capture for ambulatory and specialty pharmacy services. Supervises, mentors, and develops medication access staff, including hiring, training, performance management, and professional development.
- Collaborates with pharmacists, prescribers, clinic staff, and revenue cycle teams to streamline medication access and coordinate patient care. Acts as a liaison with payers, pharmacies, and other stakeholders to resolve authorization issues and support patient access to therapy. Supports implementation and optimization of ePA platforms and medication access tools.
- Develops reports and analyses for pharmacy leadership to support program planning, operational improvements, and strategic initiatives. Maintains knowledge of payer policies, regulatory requirements, and professional best practices related to medication access and prior authorization.
Minimum Requirements
Education / License
- MA Pharmacy Technician License
- National CPhT certification or equivalent
- High School Diploma or General Education Degree
- Associate or bachelor's Degree Preferred
Experience
- 5 years of relevant work experience in a hospital or ambulatory setting.
- Other relevant experiences include but are not limited to healthcare/business administration, health insurance, medical policy review and/or pharmacy.
The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting. Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.
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