Position Summary:
The Pharmacy Medication Navigator is responsible for assisting patients in navigating complex medication regimens, annual wellness visits, ensuring medication adherence, and optimizing access to pharmaceutical therapies. This role focuses on improving patient outcomes and HEDIS measures by coordinating with healthcare providers, pharmacists, and external support services to manage barriers to medication adherence, including financial, logistical, and educational obstacles. The navigator will work closely with clinical staff to facilitate timely access to prescribed medications and offer support through patient education and resources.
Essential Functions:
Patient Support:
- Assist patients in understanding their medication regimens and resolving any confusion or concerns.
- Act as a liaison for patients to answer questions related to their medications.
Medication Access:
- Assist patients in overcoming financial barriers to medications by connecting them with patient assistance programs, copay assistance, and discount options.
- Help patients navigate insurance requirements, including prior authorizations and formulary restrictions.
- Work with the pharmacy team and prescribers to resolve refill delays and insurance-related issues or medication denials in a timely manner.
Medication Adherence Support:
- Monitor and track patient medication adherence, utilizing electronic health records (EHR) and pharmacy systems.
- Engage with patients who are at risk of non-adherence, offering solutions such as medication synchronization, reminders, and follow-up calls.
- Collaborate with pharmacists to adjust medication plans as needed based on patient feedback and clinical assessments.
Coordination of Care:
- Serve as a liaison between the pharmacy, healthcare providers, and patients to ensure a seamless medication management process.
- Coordinate with clinical pharmacists to optimize medication therapy management (MTM) services.
- Facilitate transitions of care by ensuring patients have access to necessary medications after hospital discharge or changes in therapy.
Documentation and Reporting:
- Maintain accurate and timely documentation of patient interactions, interventions, and outcomes in EHR and pharmacy systems.
- Generate reports to track medication adherence metrics and identify areas for improvement.
Community Resource Engagement:
- Build relationships with local community resources, social workers, and healthcare providers to offer comprehensive support to patients.
- Educate patients about additional services available within the health center or community, such as transportation, food assistance, or specialty care.
Skills/Certifications:
- Strong communication and interpersonal skills, with the ability to build trust with patients.
- Knowledge of pharmaceutical therapies, insurance processes, and patient assistance programs.
- Proficiency in electronic health records (EHR) and pharmacy management systems.
- Ability to work collaboratively with healthcare professionals in a team-oriented environment.
- Excellent organizational skills and attention to detail.
- Bilingual preferred
Education
- High School Diploma or GED required. Bachelor’s degree in healthcare-related field preferred.
- Certification as a Pharmacy Technician (CPhT) is an advantage.
Experience:
- At least 2 years of experience working in a healthcare or pharmacy setting.
- Experience with annual wellness visits, patient assistance programs, insurance navigation, or medication adherence initiatives is preferred.
DISCLAIMER
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be asked to perform other duties as required and the responsibilities of the position may change.
