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  • Representative, Medication Therapy Management…

    Molina Healthcare (Augusta, GA)



    Apply Now

    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.

     


    Apply Now



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