Specialty Pharmacy Financial Access Coordinator, Lead; World Trade Center; World Trade Center Pharmacy Benefits Coordinator

$59,895 - $78,949/Yr

Mount Sinai Health System - New York, NY

Full-time - Entry Level

New York, NY

10,001+ employees

Hospitals

About the position

The World Trade Center Pharmacy Benefits Coordinator plays a crucial role in supporting patients and clinical staff by managing pharmacy benefits and ensuring access to medications. This position involves direct interaction with patients, healthcare professionals, and insurance companies to facilitate prescription coordination and address pharmacy benefit inquiries. The role is primarily remote but requires occasional on-site presence in the New York City Metropolitan area.

Responsibilities

• Works closely with the WTCHP Clinical Pharmacy Manager and the WTCHP Pharmacy team to ensure patients achieve access to medications.
• Assists in operational workflows including product overrides, prior authorizations, patient navigation, and scheduling for referred patients.
• Aids in the quality assurance process on WTCHP pharmacy claims.
• Assists in answering pharmacy benefit questions.
• Provides high-level customer service by triaging medication access questions, including medication rejections at point of sale.
• Escalates patient and provider concerns in a timely manner.
• Schedules appointments, monitors follow-ups, and addresses no-shows.
• Collaborates as a member of an interdisciplinary team and maintains effective working relationships with healthcare professionals, practitioners, patients, and families.
• Makes recommendations on system improvements to streamline clinical review processes and participates in the implementation of optimizations.
• Provides education on Program guidelines and coverage determination to interdisciplinary teams.
• Performs other duties as assigned.

Requirements

• High School Diploma or GED required; Associate's or Bachelor's degree preferred.
• 2 years of pharmacy technician experience preferred.
• Certification for pharmacy technician required (or planned within 3 months of hire).
• New York State pharmacy technician certification required (or planned within 3 months of hire).
• Retail pharmacy experience preferred.
• 1 year of customer service experience preferred.
• Experience with documentation in the electronic medical record preferred.
• Basic knowledge of Excel and Outlook preferred.
• Ability to learn additional health system and PBM portals and tools.

Nice-to-haves

• Experience in a hybrid work environment.
• Familiarity with pharmacy benefit management systems.

Benefits

• Comprehensive health insurance coverage.
• Dental and vision insurance.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Tuition reimbursement for further education.
• Professional development opportunities.