Medication Assistance Caseworker
The Martinsville Henry County Coalition for Health and Wellness is seeking qualified candidates for a MedAssist (Medication Assistance Caseworker).
The MHC Coalition for Health and Wellness is committed to providing primary health and integrated behavioral health services at our two Federally Qualified Health Center sites by promoting health, reducing health risk factors and increasing access to medical services, primarily for the uninsured and underserved in the Martinsville-Henry County area. Additionally, the Coalition offers chronic disease self-management, medication assistance, and care coordination services to patients and local residents.
Every position within the MCHCHW exists to help the organization realize its Mission of providing medical and other health related services to uninsured and underinsured members of our community. As a valued member of our staff, it is critically important that this goal be the motivation for all activities in the performance of your duties and responsibilities.
The MedAssist Caseworker (MAC) is responsible for performing functions related to the procurement and tracking of medications for qualifying patients. The MAC provides medication assistance for uninsured and underinsured patients including but not limited to obtaining needed medications directly from pharmaceutical companies. This is a customer service position. As such, it is important that this person has a very pleasant disposition and is able to communicate well with a wide range of people. This person develops and nurtures excellent relationships with patients, Clinic staff and third-party vendors and exhibits the highest levels of service quality and professionalism. He or she will work with other Health Center staff in a Patient Centered Medical Home environment that values teamwork and relentlessly pursues the highest levels of quality care for our patients. This position requires a person who can work independently and carry out assignments with minimal instruction although job tasks are performed under regular supervision.
ESSENTIAL FUNCTIONS OF THE POSITION
1. Use TPC (The Pharmacy Connection) software to assist patient’s access to available long-term maintenance medications.
2. Assist the patient in gathering appropriate documents needed to complete the MedAssist application. Enroll patients and track appropriate information in TPC software.
3. Discuss the guidelines and expectations of the MedAssist Program with patients, medical Providers and dispensing partners and hold patients accountable for compliance.
4. Support other MedAssist Programs as needed (either on-site or by remote access).
5. Order and re-order patients’ medications. Work with Providers to keep prescriptions up-to- date and scanned into the EMR. Keep up with changes in PAP programs and communicate changes to affected patients and Providers when necessary. Communicate and collaborate with pharmaceutical companies as needed.
6. Receive, process, and deliver medications to the dispenser as required. Notify patients that medications have been received. Track medicines to ensure they are picked up by the patient or properly disposed of. Assist the dispensing pharmacy with tracking and reissuing returned medicines (RTS). Follow all PAP guidelines for recalled medications.
7. Maintain patient files. Update patient applications as needed. Update and maintain the TPC Message Center and ensure that messages are processed in a timely fashion.
8. Provide medication assistance for medications not available through TPC. At the Provider’s request, a.) contact other available resources (including local pharmacies) to determine and secure the lowest cost available for medications not available through the TPC and, b.) assist patients in determining if their insurance or clinic covers specific medications (if not, identify an alternative medication that is covered). Maintain or assist with the Voucher Program if applicable. Help maintain the sample medication closet, if applicable.
9. Ensure compliance in all activities and execute any and all new programs and services requested by Virginia Healthcare Foundation. Maintain records and provide appropriate reports. Regularly attend TPC software update training(s). Comply with requests for data from Virginia Healthcare Foundation. Provide assistance to patients enrolling in Medicare part D. Maintain current knowledge of changes in Medicare part D regulations as related to enrollment. Perform other duties as assigned that are consistent with the philosophy and intent of this position and the goals of the office or practice where the MedAssist Program is located.
10. MedAssist Caseworkers will also fill in for Health Center staff as needed. These duties include, but are not limited to, answering incoming telephone calls and processing voicemail messages, scheduling and re-scheduling patient appointments, placing reminder telephone calls for Site Coordinator and scanning and emailing information for Providers.
11. Participates in training(s) opportunities to improve patient care including, but not limited to, learning evidence-based approaches to self-management support, proactively addressing the needs of patients and families in this community, cultural competency, effective communication, OSHA, HIPAA and EHR. Participate in monthly on-line program training.
12. Other duties as may be assigned from time-to-time by your supervisor that are consistent with Mission of the organization and intent of this position.
1. Obtain medicines through the Patient Assistance Programs (PAP) of pharmaceutical companies using The Pharmacy Connection (TPC) software.
• After training by TPC staff, utilize the TPC software to collect and enter data and generate PAP applications.
• Determine eligibility of client for PAP by screening for household income. This duty may be performed in conjunction with routine clinic intake.
• Obtain necessary proof of income to submit with application.
• Obtain signature of patient on application and waiver release on renewals.
• Communicate with physician or clinical staff to obtain appropriate prescriptions and physician signature on the application.
• Send completed application to pharmaceutical company.
• Track receipt of medication at physician office, clinic, or patient’s home via sign-in log, phone call or other communication.
• Order refill after confirming with patient, physician or pharmacist that order has been delivered to patient.
• Obtain renewal of proof of income annually.
• For Medicare patients, assist with obtaining medicines when patient has reached the coverage gap or “donut hole”. Refer patients for assistance with application for Low Income Subsidy as appropriate.
2. Work with providers (physicians, nurse practitioners and physician assistants) to determine the most appropriate source for free or low-cost medicines.
• Generate reference lists that may be useful to providers, such as disease class and available meds; or lists of TPC meds.
• Notify prescriber if generic equivalent is needed until brand name medicine arrives.
• As appropriate, notify prescriber of brand name equivalents to generic medicines that are available through TPC.
3. Assist the patient directly or through referral in understanding the directions for taking the medicines and in finding needed health or human services.
• Help the patient in obtaining drug information sheets.
• Make sure that patient comprehends how to take the medicines and when to call for refills.
• Help patients find alternative means of getting medication if not eligible for PAP.
• Refer patients to other organizations who may be of assistance for any other patient needs.
4. Promote the MAP through internal and external marketing and outreach.
• Assure that clinical staff in the physician’s office, clinic, or hospital setting are aware of the availability of free medicines through PAPs.
• Create helpful aids and reminders to staff such as lists of TPC meds, referral sheets, “sign here” tags.
• Post flyers and set up brochure stands in physician offices, clinics, hospitals and community locations.
• Maintain communication with physician offices and other referral sources.
• Work with marketing personnel in the organization to promote the MAP in the community.
5. Comply with requirements for TPC use and for VHCF reporting
• Upload data the first of each month
• Run TPC reports as requested.
• Attend Roundtables, training sessions, and conference calls.
• Work with supervisor to submit timely progress reports to VHCF.
• Notify TPC staff and Program Officer promptly of changes in personnel or other modifications in the program.
Required Education, Experience & Abilities:
- High school diploma or GED.
- Strong computer skills including proficiency in Microsoft Office suite and working knowledge of Electronic Medical Record systems (EMRs).
- Understanding and working knowledge of medications and related medical terminology.
- Strong organizational and communication skills. Comfortable working with diverse populations.
- Ability to work efficiently under pressure and succeed in a fast-paced environment with high levels of distraction.
- Valid Virginia driver’s license.
- Ability to transport oneself to meetings and other work sites as needed including pharmacies.
- A passion and concern for the target population served by the Health Center.
Preferred Education, Experience & Abilities
- Licensed pharmacy technician preferred, or willingness to be trained
- Prior experience in the medical field and/or pharmacology. Previous experience with pharmaceutical patient assistance programs or TPC (The Pharmacy Connection).
- Medical office background desirable
- Experience with eClinical Works (eCW)
- Marketing or outreach experience desirable
- Bilingual preferred (English and Spanish).
The Successful MAC
- Demonstrates initiative and ability to function independently
- Is able to type a minimum of 40 wpm
- Has excellent interpersonal communication skills
- Is detail-oriented
- Has good writing skills and ability to follow directions
Paid Holidays – 8
Paid Sick Leave
Short and Long-Term Disability
Simple IRA Plan (with company match)
Medical, Dental and Vision Insurance
Other voluntary benefit plans available
Resumes can be submitted by clicking here or to MHC Coalition for Health and Wellness, 22 E. Church Street, Martinsville, VA 24112.
MHCCHW is an Equal Opportunity Employer: Minorities/Women/Protected Veterans/Disabled