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Clinical Finance Case Management Specialist 1 (HS)

The Ohio State University Wexner Medical Center
Columbus, Ohio
Full time
4 weeks ago

Scope of Position

The Ohio State University Medical Center is committed to improving access and service to customers. The Medication Assistance Program Coordinator (MAPC) functions as an integral member of the health care team to reflect a culture of cooperation, enthusiasm and mutual respect. This position coordinates patient access to medications necessary for their treatment, regardless of their ability to pay for both inpatients and outpatients of the Ohio State University Medical Center and Arthur G James Cancer Hospital. The MAPC works with the patient and prescriber to obtain free and discounted pharmaceuticals and grant awards for patients (uninsured, underinsured, indigent, etc.) from pharmaceutical manufacturer patient assistance programs (PMAPs), non-profit disease-based assistance and state and local agencies.

Position Summary

The MAPC is knowledgeable about PMAPs, pharmaceutical terminology, insurance coverage (limitations, requirements, eligibility, pharmacy formulary, prior authorization, coordination of benefits etc), available community and national resources, ICD-10 codes, and determinants of financial need. Displays an understanding of pharmaceutical terminology (brand, generic, dose, route, etc). They provide all customers (patients and clinicians) with accurate and up-to-date information and work closely with financial counselors and clinical staff to assist patients who otherwise cannot afford medication to gain access to therapy.

Minimum Qualifications

For Hire: Active OH Board of Pharmacy Certified Pharmacy Technician required, Associate or Bachelor degree is preferred. Experience in finance, insurance, insurance appeals, medication and medical terminology desired. Minimum of 1 year pharmacy experience preferred. Ability to work in self-directed manner while interacting with patients, prescribers and all medical center faculty and staff while proactively preparing for medication needs. Ability to communicate clearly with health care team. Familiarity with OSUMC and its entities preferred. Strong demonstrated communication skills. Experience with Windows, Excel, Access, PowerPoint, and intranet/internet navigation tools as well as system content. Must be highly organized, detail oriented, and able to manage multiple projects at a time.


On going:
Maintains knowledge related to product/service line, disease specific treatment and medications, quality improvement, cost reduction for medications, scheduling, registration, precertification, non-profit disease-based assistance, financial counseling and insurance policies and procedures, insurance benefits and available state and federal prescription subsidy information. Meets mandatory educational and health requirements as well as ongoing department competencies.

Regular 40 First Shift
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