Pharmacy Administrative Case Manager (CMSL)

We are seeking a Pharmacy Administrative Case Manager (CMSL) to join our team! This role combines traditional pharmacy technician skills with patient-facing responsibilities such as enrollment, documentation, compliance, outreach, and service linkage. The goal is to ensure uninterrupted access to Ryan White health services and HIV medications in accordance with Texas Health and Human Services (HHSC) guidelines. 

Responsibilities:

Enroll new and existing patients in the Texas HIV Medication Program (THMP).

Collect, verify, and process required documents, including income, residency, insurance status, lab results, and provider forms.

Educate patients on THMP eligibility requirements, renewal timelines, and program benefits.

Track application statuses and follow up with patients and providers to prevent coverage gaps.

Complete recertifications and renewals within required timeframes.

Maintain confidentiality while providing culturally competent and nonjudgmental patient support.

Verify patient information to determine eligibility for various programs.

Inform patients about the availability of government-funded and discount programs.

Complete enrollment applications through electronic systems.

Enter and maintain accurate patient and enrollment data in pharmacy and THMP systems.

Assist with prescription processing once enrollment is confirmed.

Maintain organized electronic and paper records in compliance with HIPAA and THMP standards.

Identify and escalate eligibility or access issues to the pharmacist or program supervisor.

Ensure adherence to THMP, HHSC, and pharmacy policies and procedures.

Stay updated on THMP program changes, eligibility criteria, and state regulations.

Participate in audits, reporting, and quality improvement activities as needed.

Coordinate with pharmacists, providers, healthcare professionals, clinics, and city/state agencies regarding patient eligibility and community resources.

Conduct outreach activities to identify and screen clients for service needs.

Provide information and referrals to medical and psychosocial services as needed.

Advocate on behalf of clients to reduce gaps in service and address barriers to care.

Qualifications:

High School Diploma or GED.

Active Texas Pharmacy Technician registration (or eligibility to obtain).

Minimum of 1 year of experience in HIV-related work.

Experience with patient enrollment, benefits coordination, or healthcare documentation.

Experience in a primary care or family practice setting.

Excellent written and verbal communication skills.

Strong attention to detail and organizational skills.

Self-motivated with the ability to work independently.

Strong professional ethics and boundaries.

Ability to work with frequent interruptions while maintaining emotional control under stress.

Bilingual (English/Spanish) is a plus.

Working Conditions:

Community, clinic-based, or specialty pharmacy setting.

Frequent interaction with patients, healthcare providers, and program administrators.

Work schedule requires attendance on two Saturdays (half-day AM) per quarter, depending on current staffing patterns.

The position may occasionally require sitting, standing, bending, and very light lifting (up to 20 pounds or an equivalent weight).

Employee Benefits:

Paid Time Off Plan, Comprehensive Medical/Dental/Vision, Life Insurance, 401k (6% Match), Paid Federal Holidays

EEO Statement: St. Hope Healthcare is an equal opportunity employer and will not discriminate against any employee or applicant on the basis of age, color, disability, gender, national origin, race, religion, sexual orientation, veteran status, or any classification protected by federal, state, or local law.