5 Access Specialist jobs in Weymouth

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.

The Medication Access Specialist will fulfill all of the job responsibilities as needed in accordance to the SPL role. Individual will need to be well versed in all processes pertaining to, but not limited to, prior authorizations, financial assistance, and general patient access programs. Will be working directly with Med Auth and Access leadership along with other MAS's to execute training and fully support team in maintaining high quality standard of care. Individual will also need to be fully proficient in all platforms used by the team(salesforce, EPIC, CMM, UptoDate, etc) so they can fully support and guide when help is needed. This is a hybrid role 2 days on site, 3 days from home, and additionally requires flexible with schedule to pick up additional on-site days as needed for training and business operations.

Job Description:

Essential Responsibilities:

1. Serves as a subject matter expert for physicians, administrators, clinical staff, pharmacy staff, and third party payers for issues regarding prior authorization approvals, ambulatory infusion reimbursement and Patient Assistance programs.

2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic administered or infusion medications through evaluating necessity of prior authorization and identification of formulary alternatives.

3. Obtains initial and renewal insurance authorization for infusion medications as required by insurance plans and provide infusion cost estimates to patients or clinic staff.

4. Facilitates patient enrollment in available programs, handles customized communications, ensures ongoing claims processing accuracy and efficient delivery throughout the treatment period with a high-touch, member centric process and manages plan reporting.

5. Manages enrollment and services under the Employee Variable Co-Pay Program by reducing employee and plan sponsor costs and minimizing compliance risks. Assists patients with various forms of financial assistance by serving as a patient advocate to communicate and coordinate with drug manufacturers, PBMs and dispensing pharmacies.

6. Provides exceptional customer service to internal and external customers; resolves any patient requests in a timely and accurate manner; escalates complaints accordingly; maintains frequent phone contact with patient, provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate.

7. Serves as the direct patient and provider contact for pharmacy benefits information, clinical and program information. Coordinates services with providers, specialty pharmacies and national account managers to improve turnaround time for patients.

8. Manages multiple strategic initiatives simultaneously and reprioritize where necessary, independently and effectively resolves complex accounts, and determines methods and procedures on new or special assignments with minimal supervision.

9. Networks with key payor and manufacture contacts inside and outside own area of expertise.

10. Provides training and support to inter-departmental associates. Cross cover other primary care and specialty clinics as needed.

Required Qualifications:

High School diploma or GED required.

Pharmacy Technician (Massachusetts) - Massachusetts Board of Pharmacy

3-5 years related work experience required in specialty pharmacy and medical prior authorization experience or a minimum of 4 years of pharmacy work experience.

Working knowledge of Common Procedural Terminology (CPT), Health Care Procedural Coding System (HCPCS) J Codes and International Classification of Diseases (ICD-10).

Experience with medical buy & bill and specialty clinic authorization management.

Must obtain PACS certification within twelve months of hire.

Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.

Preferred Qualifications:

Prior lead or supervisor experience. Familiarity with 340B drug program.

Deep knowledge of medication use in MS, RA, GI, transplant, hepatitis C, infectious disease (including HIV), and/or oncology a plus.

Advanced Certificate Pharmacy Technician credential (CPhT-Adv).

Competencies:

Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.

Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.

Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.

Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers.

Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.

Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.

Team Work: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.

Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled

**Job Type:** Regular
**Time Type:** Full time
**Work Shift:** Day (United States of America)
**FLSA Status:** Non-Exempt
**When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.**
The Medication Access Specialist will fulfill all of the job responsibilities as needed in accordance to the SPL role. Individual will need to be well versed in all processes pertaining to, but not limited to, prior authorizations, financial assistance, and general patient access programs. Will be working directly with Med Auth and Access leadership along with other MAS's to execute training and fully support team in maintaining high quality standard of care. Individual will also need to be fully proficient in all platforms used by the team(salesforce, EPIC, CMM, UptoDate, etc) so they can fully support and guide when help is needed. This is a hybrid role 2 days on site, 3 days from home, and additionally requires flexible with schedule to pick up additional on-site days as needed for training and business operations.
**Job Description:**
**Essential Responsibilities:**
1. Serves as a subject matter expert for physicians, administrators, clinical staff, pharmacy staff, and third party payers for issues regarding prior authorization approvals, ambulatory infusion reimbursement and Patient Assistance programs.
2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic administered or infusion medications through evaluating necessity of prior authorization and identification of formulary alternatives.
3. Obtains initial and renewal insurance authorization for infusion medications as required by insurance plans and provide infusion cost estimates to patients or clinic staff.
4. Facilitates patient enrollment in available programs, handles customized communications, ensures ongoing claims processing accuracy and efficient delivery throughout the treatment period with a high-touch, member centric process and manages plan reporting.
5. Manages enrollment and services under the Employee Variable Co-Pay Program by reducing employee and plan sponsor costs and minimizing compliance risks. Assists patients with various forms of financial assistance by serving as a patient advocate to communicate and coordinate with drug manufacturers, PBMs and dispensing pharmacies.
6. Provides exceptional customer service to internal and external customers; resolves any patient requests in a timely and accurate manner; escalates complaints accordingly; maintains frequent phone contact with patient, provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate.
7. Serves as the direct patient and provider contact for pharmacy benefits information, clinical and program information. Coordinates services with providers, specialty pharmacies and national account managers to improve turnaround time for patients.
8. Manages multiple strategic initiatives simultaneously and reprioritize where necessary, independently and effectively resolves complex accounts, and determines methods and procedures on new or special assignments with minimal supervision.
9. Networks with key payor and manufacture contacts inside and outside own area of expertise.
10. Provides training and support to inter-departmental associates. Cross cover other primary care and specialty clinics as needed.
**Required Qualifications:**
High School diploma or GED required.
Pharmacy Technician (Massachusetts) - Massachusetts Board of Pharmacy
3-5 years related work experience required in specialty pharmacy and medical prior authorization experience or a minimum of 4 years of pharmacy work experience.
Working knowledge of Common Procedural Terminology (CPT), Health Care Procedural Coding System (HCPCS) J Codes and International Classification of Diseases (ICD-10).
Experience with medical buy & bill and specialty clinic authorization management.
Must obtain PACS certification within twelve months of hire.
Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
**Preferred Qualifications:**
Prior lead or supervisor experience. Familiarity with 340B drug program.
Deep knowledge of medication use in MS, RA, GI, transplant, hepatitis C, infectious disease (including HIV), and/or oncology a plus.
Advanced Certificate Pharmacy Technician credential (CPhT-Adv).
**Competencies:**
**Decision Making:** Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.
**Problem Solving:** Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
**Independence of Action:** Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
**Written Communications:** Ability to communicate clearly and effectively in written English with internal and external customers.
**Oral Communications:** Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.
**Knowledge:** Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.
**Team Work:** Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.
**Customer Service:** Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
**Physical Nature of the Job:**
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally
**As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more ( about this requirement.**
**More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.**
**Equal Opportunity** **Employer/Veterans/Disabled**

Training/Technical Assistance Specialist - Health Access & Outreach

Requisition Number: 9435

Location: Commerce Place

Work Days: M-F occasionally weekends

Category: Professional and Management

Department: Health Access & Outreach

Job Type: Full time

Work Shift: Day

Hours/Week: 40.00

Union Name: Non Union

Summary:

CHA's Health Education, Access and Outreach (HEAO) Programs aregrant and non-grant funded programs that increase linkages between patients, communities and health care, social determinants of health, outreach, training, and health education on topics such as navigating the US healthcare system, aging and emotional wellness, and communicable and non-communicable diseases or conditions such as hypertension. Position is contingent upon continued availability of grant funding.

Job purpose:

The candidate will oversee and lead the Community Health Worker (CHW) training program and curriculum, while also developing internal training initiatives for CHA staff. Additionally, the role will involve supporting and expanding Health Education Access & Outreach training and technical assistance programs for external partners across various organizations and coordinating the Volunteer Health Advisor (VHA) program, overseeing volunteers' completion of CHW training, supervising their placements, and providing ongoing mentoring and support.

Other Information

• The ideal candidate needs strong presentation, training and public speaking skills, the ability to communicate effectively in writing and speech, and the desire to collaborate with and engage others. The qualified candidate will have work experience in education, healthcare, social services, or a related field, the ability to be self-motivated, with a commitment to the mission of the Cambridge Health Alliance.

• Bachelor's degree preferred in education, public health, social services, or related field.

• Three to five (3 - 5) years previous experience working with grant funded programs or research, or education/training related roles.

• Extensive knowledge of community based organizations, programs and services in targeted community area preferred

• Experience working with community coalitions or partnerships preferred.

• Strong knowledge on the principles of outreach, training/education and partnership development

• Experience working in a community setting and with grant funded programs a plus

• Competency with basic computer skills (word processing, spreadsheet, database entry, internet) and fluency with presentation tools

• Oral and written fluency in English and at least one other language (preferably Spanish, Haitian Creole, Arabic or Hindi) preferred.

• Ability to travel to surrounding communities for program activities.

In keeping with federal, state and local laws, Cambridge Health Alliance (CHA) policy forbids employees and associates to discriminate against anyone based on race, religion, color, gender, age, marital status, national origin, sexual orientation, gender identity, veteran status, disability or any other characteristic protected by law. We are committed to establishing and maintaining a workplace free of discrimination. We are fully committed to equal employment opportunity. We will not tolerate unlawful discrimination in the recruitment, hiring, termination, promotion, salary treatment or any other condition of employment or career development. Furthermore, we will not tolerate the use of discriminatory slurs, or other remarks, jokes or conduct, that in the judgment of CHA, encourage or permit an offensive or hostile work environment.

Cambridge Health Alliance brings Care to the People - including your neighbors, friends and family. Our local hospitals and care centers serve our vibrant, diverse communities, and play an integral role in improving health. As passionate advocates for the underserved, we actively partner with our communities to take on challenging public health issues, and conduct important research to help reduce barriers to care. We believe that everyone deserves access to high quality, convenient health care. This is why our employees believe in where they work and why many build long, rewarding careers at CHA.

Healthcare is changing rapidly. CHA has a strategic plan that charts a proactive course for our future. It is built on a vision of equity and excellence for everyone, every time. It also recognizes that our workforce is our most valuable asset and prioritizes competitive salaries, benefits and professional development opportunities for employees. The strategic plan is changing the way we provide care and improving the health and experience of our patients; we are looking for smart, committed, compassionate people who want to be part of making our vision of better health and equity a reality.

At CHA, you can believe in where you work and go home every day knowing you made a difference. Join our team and help us bring Care to the People.

Training/Technical Assistance Specialist - Health Access & Outreach
**Requisition Number:** 9435
**Location:** Commerce Place
**Work Days:** M-F occasionally weekends
**Category:** Professional and Management
**Department:** Health Access & Outreach
**Job Type:** Full time
**Work Shift:** Day
**Hours/Week:** 40.00
**Union Name:** Non Union
Summary:
CHA's Health Education, Access and Outreach (HEAO) Programs aregrant and non-grant funded programs that increase linkages between patients, communities and health care, social determinants of health, outreach, training, and health education on topics such as navigating the US healthcare system, aging and emotional wellness, and communicable and non-communicable diseases or conditions such as hypertension. Position is contingent upon continued availability of grant funding.
Job purpose:
The candidate will oversee and lead the Community Health Worker (CHW) training program and curriculum, while also developing internal training initiatives for CHA staff. Additionally, the role will involve supporting and expanding Health Education Access & Outreach training and technical assistance programs for external partners across various organizations and coordinating the Volunteer Health Advisor (VHA) program, overseeing volunteers' completion of CHW training, supervising their placements, and providing ongoing mentoring and support.
Other Information
+ The ideal candidate needs strong presentation, training and public speaking skills, the ability to communicate effectively in writing and speech, and the desire to collaborate with and engage others. The qualified candidate will have work experience in education, healthcare, social services, or a related field, the ability to be self-motivated, with a commitment to the mission of the Cambridge Health Alliance.
+ Bachelor's degree preferred in education, public health, social services, or related field.
+ Three to five (3 - 5) years previous experience working with grant funded programs or research, or education/training related roles.
+ Extensive knowledge of community based organizations, programs and services in targeted community area preferred
+ Experience working with community coalitions or partnerships preferred.
+ Strong knowledge on the principles of outreach, training/education and partnership development
+ Experience working in a community setting and with grant funded programs a plus
+ Competency with basic computer skills (word processing, spreadsheet, database entry, internet) and fluency with presentation tools
+ Oral and written fluency in English and at least one other language (preferably Spanish, Haitian Creole, Arabic or Hindi) preferred.
+ Ability to travel to surrounding communities for program activities.
In keeping with federal, state and local laws, Cambridge Health Alliance (CHA) policy forbids employees and associates to discriminate against anyone based on race, religion, color, gender, age, marital status, national origin, sexual orientation, gender identity, veteran status, disability or any other characteristic protected by law. We are committed to establishing and maintaining a workplace free of discrimination. We are fully committed to equal employment opportunity. We will not tolerate unlawful discrimination in the recruitment, hiring, termination, promotion, salary treatment or any other condition of employment or career development. Furthermore, we will not tolerate the use of discriminatory slurs, or other remarks, jokes or conduct, that in the judgment of CHA, encourage or permit an offensive or hostile work environment.
_Cambridge Health Alliance brings Care to the People - including your neighbors, friends and family. Our local hospitals and care centers serve our vibrant, diverse communities, and play an integral role in improving health. As passionate advocates for the underserved, we actively partner with our communities to take on challenging public health issues, and conduct important research to help reduce barriers to care. We believe that everyone deserves access to high quality, convenient health care. This is why our employees believe in where they work and why many build long, rewarding careers at CHA._
_Healthcare is changing rapidly. CHA has a strategic plan that charts a proactive course for our future. It is built on a vision of equity and excellence for everyone, every time. It also recognizes that our workforce is our most valuable asset and prioritizes competitive salaries, benefits and professional development opportunities for employees. The strategic plan is changing the way we provide care and improving the health and experience of our patients; we are looking for smart, committed, compassionate people who want to be part of making our vision of better health and equity a reality._
_At CHA, you can believe in where you work and go home every day knowing you made a difference. Join our team and help us bring Care to the People._