Managed Care Certified Pharmacy Technician

Position Summary :

Provides high quality and effective assistance to the pharmacy team on various clinical and data driven activities. Such activities will include, but not be limited to patient care, customer relationship management, internal customer service, data gathering, report preparation, assisting in the training of IPPE / APPE students, and other related duties.

Essential Duties and Responsibilities :

• Conducts patient outreach calls to improve HEDIS outcomes and assists in daily medication therapy management (MTM) calls to eligible members.
• Address, triage, investigate and resolve customer relationship management (CRM) concerns. Identify concerns that require the clinical pharmacist and direct for review.
• Assist internal team members with basic pharmacy related questions, such as verifying members’ claims activities for eligibility, addressing weekly comprehensive drug list questions related to medication coverage etc.
• Assist the clinical pharmacist with grievance and appeals preparations as needed. Assist with prescription related issues identified during clinical rounds.
• Conduct calls, send faxes to pharmacies, PBM’s and providers offices to assist members and internal teams with medication related concerns.
• Prepare and send documentation related to MTM and clinical programs to appropriate recipients.
• Complete assigned reports for pharmacist review as needed.
• Document all clinical encounters in the appropriate clinical platforms. Documentation should describe patient interactions, problems, resolutions, and referral information (when applicable).
• Always abide by HIPPA and CCP confidentiality policies. Always HIPAA verify using 2 identifiers when making or receiving calls.
• Assist in the initial workflow and systems training of IPPE / APPE students from colleges of pharmacy partnered with CCP for these learning experiences.
• Identify when to escalate concerns to the clinical pharmacist or pharmacy director when there is uncertainty or barriers to addressing a situation.
• Keep work areas clean and organized.
• Complete member-related tasks within the same business day whenever possible . Address member concerns in a timely manner.
• Refer all prescribers (MD, DO, APRN etc.) and customer calls related to medical questions to the Pharmacist.

Work Schedule :

As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule.

Staff are able to work from home 3 days a week and will report to the office 2 days a week.

The company reserves the right to change the work schedules based on the company needs.

Physical Demands :

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear.

The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl.

The employee must occasionally lift and / or move up to 15 pounds.

Work Environment :

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job.

The environment includes work inside / outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique.

We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.

Qualifications

• Must be a registered certified pharmacy technician for the State of Florida.
• Must have 3 plus years’ experience working as a pharmacy technician in hospital, managed care (preferred) or retail setting with previous hospital or managed care experience.
• Experience in medication therapy management (MTM) activities (preferred) and / or assisting in patient counseling activities.
• Experience in resolving medication claims concerns for members, providers, and pharmacies.
• Proficiency with Microsoft Office products (preferred).
• Experience working with any of the following populations : Medicaid, Medicare, Long Term Care (LTC) or Florida Health Kids (FHK).
• Experience with using pharmacy tools to research and retrieve clinical documents. Comfortable retrieving clinical studies or articles that may be requested by the pharmacist.
• Must be able to type 40- 45 wpm minimum.
6 days ago