Molina Healthcare

Compensation

Full Description

JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties • Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. • Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. • Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. • Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. • Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. • Utilizes appropriate resources to ensure member contact information is current and up-to-date. • Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. • Interacts with appropriate primary care providers to ensure member registry is current and accurate. • Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. • Proactively identifies ways to improve member relations. • Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications • At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. • Excellent customer service skills. • Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. • Ability to multi-task applications while speaking with members. • Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. • Ability to meet established deadlines. • Ability to function independently and manage multiple projects. • Excellent verbal and written communication skills, including excellent phone etiquette. • Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications • Health care industry experience. • Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.