Representative, Pharmacy
6 days ago
Pharmacy Call Center Representative Provides customer service support for inbound/outbound 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 from members, providers and pharmacies in accordance with departmental policies, state regulations, and standards. Provides coordination and processing of pharmacy prior authorization requests and/or appeals. Explains point-of-sale claims adjudication, state, and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. Assists members and providers with initiating verbal and written coverage determinations and appeals. Records calls accurately within the pharmacy call tracking system. Maintains established pharmacy call quality and quantity standards. Interacts with appropriate primary care providers to ensure member registry is current and accurate. Supports pharmacists with completion of comprehensive medication reviews (CMRs) through pre-work up to case preparation. Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications: At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. Excellent customer service skills. Ability to work independently when assigned special projects. 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. Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications: Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license. Health care industry experience. 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.
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Representative, Pharmacy
4 weeks ago
Warren, United States Michigan Staffing Full timePharmacy Call Center Representative Provides customer service support for inbound/outbound 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...
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Representative, Pharmacy
2 weeks ago
Warren, MI, United States Michigan Staffing Full timePharmacy Call Center Representative Provides customer service support for inbound/outbound 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...
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Representative, Pharmacy
7 days ago
Warren, MI, United States Michigan Staffing Full timePharmacy Call Center Representative Provides customer service support for inbound/outbound 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...
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Representative, Pharmacy
2 weeks ago
Warren, MI, United States Michigan Staffing Full timePharmacy Call Center Representative Provides customer service support for inbound/outbound 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...
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Representative, Pharmacy
6 days ago
Warren, MI, United States Michigan Staffing Full timePharmacy Call Center Representative Provides customer service support for inbound/outbound 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...
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Warren, Ohio, United States Bon Secours Mercy Health Full timeAt Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.Reports to Title:Pharmacy Supervisor, Manager, or DirectorSummary Of Primary Function/General Purpose Of PositionUnder general supervision,...
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St. Joseph Warren Hospital, United States Bon Secours Mercy Health Full timeThank you for considering a career at Mercy HealthScheduled Weekly Hours:0.01Work Shift:All Work Shifts (United States of America)Reports to Title: Pharmacy Supervisor, Manager, or DirectorSummary of Primary Function/General Purpose of Position Under general supervision, assist the pharmacist in processing of medication orders by selecting, assembling, and...
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Registered Nurse
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Warren, United States Michigan Staffing Full timeRegistered Nurse - Behavioral Health Provides leadership in the coordination and delivery of quality compassionate patient care. Utilizes the nursing process of assessment, planning, implementation, and evaluation, to provide, delegate, supervise and document care and teaching of patients and family. Effectively communicates pertinent patient/family...
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Store Associate
4 weeks ago
Warren, United States Rhode Island Staffing Full timeRetail Store AssociateAt CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. We're shaping the future of health care for people, businesses, and communities. With your talents and expertise, you can help us play a more active and supportive...
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Shift Supervisor Trainee
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Warren, United States Michigan Staffing Full timeShift Supervisor TraineeAt CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven...
