Job Details

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.