Position Overview: Position will focus on addressing Part C and Part D STARs and Quality gaps directly affected by medication related drug therapy issues within the scope of the technician licensure and act as a liaison between members and health plan. Working directly with Medicare populations, who have been identified to benefit from a direct contact familiar with the formulary, and Part D benefits and measure specifications to promote adherence, statin use, utilization of mail order, member satisfaction with the drug plan and CMR completion rate. Must be able to assess other needs and providing a resource whenever possible while tracking and overcoming identified barriers. Candidate must have strong customer service and interpersonal skills to be able to quickly identify opportunity to build a working relationship with at-risk membership.
Work Experience: 1 year customer service experience, 6 months pharmacy experience required. Knowledge of health insurance pharmacy claims preferred.
Education, Certificates, Licenses: High school degree or equivalent required. Pharmacy Technician Certification required. Active Oregon license in good standing required.
Knowledge: Microsoft Office software including Word and Excel, medical terminology, call tracking software, mainframe and medical management software. Ability to work under time pressure. Ability to prioritize responsibilities and to diplomatically handle demanding situations. Follow strict guidelines to ensure confidentiality is maintained at all times. Ability to work independently as well as within a team. Ability to work across business and system groups at all levels. Ability to compile and report out on relevant data.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.