Specialty Quality Coordinator

Overview

Reporting to the Assistant Director of Pharmacy Outpatient Services, the Specialty Quality Coordinator ensures the pharmacy maintains compliance with URAC and ACHC accreditation standards. In this role, the technician assists with standard reporting, accreditation renewals, billing, and audit record management. Additionally, the position oversees the daily tasks of Medication Access Specialists to ensure adherence to all departmental policies and procedures

Responsibilities

Run reports for quarterly QMC meetings and prepare all the QMC notes and score cards.

Complete annual reports including the quality and summary of QMC

Prepare all annual/PAC meeting notes

Ensure pharmacy policy and procedures are up to date and meet accreditation standards

Verification of patient assessments completed within the appropriate time frame

Verification of Temperature and Humidity Monitoring

Manage marketing, communication logs and compliance logs

Manage patient facing materials – handbook, education, new patient pamphlet, etc. 

Manage annual compliance requirements (ie. Fire drills, hazard training, business continuity testing, organizational charts, communication materials, website)

Ensure HR has all items need for audits, including annual license verification

Track incident/accident reports, complaints and other issues

Complete all insurance audits received daily

Assist with annual 340B audits, including auditing of 340B prescriptionssent to 340B contract pharmacy

Ensure outstanding claims are paid in a timely manner

Assist Pharmacists, MDs and Nurses in Celgene prescription

Ensure pharmacy staff have completed yearlycompetency training

Oversee day-to-day procedures for Medication Access Specialist in Patient Assistance (PAP) and Prior Authorization (PA)

Oversee day-to-day procedures for Medication Assistant Coordinator in Drug Recovery Program

Audit and Verify records and compliance to the drug recovery program

Assist Patient Medication Access Specialist and Medication Assistant Coordinator with scheduling conflicts if needed. 

Make sure all policies are kept up to date for Medication Access Specialist (PAP and PA) and Medication Assistant Coordinator.

Ensure compliance with all policies and procedures for Patient Advocate Coordinators (PAP and PA) and Retail Financial Assistance. 

Other duties as assigned by the Assistant Director of Outpatient Pharmacy Services

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.

• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.

• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Qualifications

Registration: Active Alabama Pharmacy Technician registration by start date.

Certification: National PTCB or ExCPT certification required.

Education: High School diploma or equivalent required.  Bachelor’s degree preferred.

Required: 1+ years in medication reimbursement, insurance preauthorization, patient assistance programs, and URAC/ACHC accreditation standards.

Preferred: 3+ years of pharmacy practice experience.

Technical: Proficient in Microsoft Office, pharmacy equipment, and pharmacology (medication classes).

Professional: Strong interpersonal, telephone, and communication skills.

Execution: Detail-oriented with a focus on follow-up and the ability to meet deadlines under pressure.

Must be able to read, write legibly, speak, and comprehend English

WORKING CONDITIONS

Able to stand, walk, reach, sit, crouch and stoop for extended periods of time.  Must be able to carry objects weighing 35 pounds.  Requires good motor coordination with good manual and finger dexterity.  Must have the ability to communicate with staff and patients of all ages.  Physical presence onsite is essential.  Hearing and vision must be normal or corrected to within normal range.  Able to perform the duties with or without reasonable accommodation.