Blue Cross and Blue Shield of North Carolina

Compensation

Full Description

Job Description The Pharmacy Quality Specialist will provide assistance to Pharmacists and/or Advanced Practice Clinicians to support Medication Therapy Management (MTM) and quality programs. The Pharmacy Quality Specialist will complete outreach calls to eligible health plan members and/or caregivers to introduce and explain the MTM benefit, verify and obtain demographic and medication-related information, including documentation of medication lists, schedule appointments for the MTM Pharmacist to complete the comprehensive medication review or target intervention. This position will also support Medicare Star and other quality initiatives. ***Note: The designated shift will be 10 AM - 7 PM EST (Monday - Friday)*** What You Will Do Verify member demographic information, provider and pharmacy contact information and enter into the Medication Therapy Management (MTM) platform as needed Obtain, verify and document current medication lists into the designated MTM platform Contact members to introduce and explain the benefits of the MTM program and follow up as needed and to schedule appointments for the MTM Pharmacist to complete the Comprehensive Medication Review or the Targeted Intervention Receive and respond to calls from provider offices, members and pharmacies; make determinations of appropriate action required from calls and escalate calls as needed Coordinate outbound faxing and subsequent follow-up calls with health care providers Assess and interprets member needs and requirements, triaging to a clinical pharmacist or other areas when appropriate Support Medicare Star and other quality initiatives What You Bring High school diploma or GED 3+ years of experience in related field. Active pharmacy technician license in the state of North Carolina (PTCB: Pharmacy Technician Certification Board - Nationally Accredited Certification Exam), preferred. Bonus Points (preferred qualifications) Strong customer service skills with demonstrated ability to engage with patients and health plan members in a professional and empathetic manner. Excellent communication skills tailored to customer, patient, and member needs. What You’ll Get The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community Work-life balance, flexibility, and the autonomy to do great work Medical, dental, and vision coverage along with numerous health and wellness programs Parental leave and support plus adoption and surrogacy assistance Career development programs and tuition reimbursement for continued education 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $45,761.00 - $73,217.00 Skills About Us It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives. Authorization to Work in the United States We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview for English or Visión General de E-Verify for Español. Request Accommodations Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at HR.Staffing@bcbsnc.com. For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming