Specialty Practice Pharmacy Analyst

Scope of Position

The Medication Access Pharmacist collaborates with clinic teams, specialists, prior authorization, and revenue integrity staff to ensure required clinical information is complete for submission of prior authorization requests and approval. Responsibilities include reviewing off-label regimens for appropriate clinical support, verifying provider signed notes, aligning treatment plan dates, and escalating issues as needed. The position also involves direct patient communication, addressing insurance barriers, delivering ABNs, explaining treatment-related next steps, and responding to patient questions. Additionally, the pharmacist serves as a resource for the prior authorization and medication assistance teams, supports provider education, leads process improvement initiatives, and participates in relevant departmental or hospital committees.

Position Summary

This position is responsible for ensuring accurate and complete clinical information for prior authorization, assisting with appeal content and peer-to-peer reviews, and escalating issues for timely resolution. The Medication Access Pharmacist must demonstrate mastery of oncology treatment modalities, expected outcomes, insurance requirements, and clinic-specific workflows, while demonstrating exceptional communication, interpersonal, and organizational skills. The role requires collaboration with providers, nursing, pharmacy, financial counselors, scheduling, and PCRMs, and a deep understanding of processes and operations within the practice area.

Minimum Qualifications

Bachelor's Degree in Pharmacy required. Doctoral Degree in Pharmacy preferred. 2 years of relevant experience required. 2-4 years of relevant experience preferred.