MTM Pharmacy Technician

Seeking a MTM Pharmacist Technician for a 100% Remote position.

Works under supervision of the Director of Pharmacy Government Programs and Medicare Clinical Pharmacist. Responsible for making phones calls to members to support them with closing Stars care gaps. Responsibilities also include identification of medication adherence barriers and assisting with resolution of the identified barrier. Working with the Medicare Pharmacy team to support achievement of the overall pharmacy Stars goal.

• Make outbound phone calls to members to close gaps in care.
• Field incoming member return calls to address gaps in care.
• Manage daily reports and call lists to prioritize members needing a prescription refill
• Identify and address barriers preventing members from being adherent with their medications
• Identify adherence issues that require escalation to a pharmacist and facilitate the escalation process
• Document Barriers, actions taken, follow ups and outcomes that result from member interventions
• Support the Clinical Pharmacists with ad hoc outreach as needed
• Research alternative phone numbers for members when unable to reach due to inaccurate contact information
• Effectively manage internal and external communications
• Collaborate with the MTM team, other pharmacy and Stars team members to achieve the Stars goals
• Build rapport, influence members and their care givers to improve adherence with prescribed medications
• Contact pharmacies to facilitate prescription refills as needed
• Identify and properly escalate member’s non-clinical Pharmacy related benefit/plan questions and non-clinical Pharmacy related benefit/plan questions.

Required

• Pharmacy Technician Certification
• Required minimum 5 years direct pharmacy work experience
• Required minimum 3 years call center or direct member outreach experience

Preferred

• 3 years Medicare Stars programs member outreach experience

Additional Required Experience

• The essential functions listed represent the major duties of this role, additional duties may be assigned.
• Participates in required MTM Call Center operational meetings and training sessions, as necessary.
• Support MTM services with pharmacist oversight. Receive and respond to calls from members, provider/physician’s offices, and pharmacies. Makes outbound calls to physicians and pharmacies.
• Responds to requests from beneficiary service and other issues. Contacts beneficiaries to explain the MTM program, transfer members to pharmacists and schedules calls for pharmacist to complete patient interview.
• Contacts beneficiaries as needed for quarterly follow-ups. Screens inbound phone calls and voicemail messages, determines appropriate action and escalates calls as needed. Ensures first call resolution. Effectively assesses beneficiary needs and concerns. Requests additional help when needed.
• Research demographic for dated member’s information.
• Support Pharmacists with ensuring CMS requirements are met for all operations including medication therapy management.
• Evaluate documentation compiled for Comprehensive Medication Reviews (CMRs) and ensure accuracy prior to mailing.
• Interact with qualified members to schedule CMRs or complete with the opt-out process.
• Interact with medical providers to ensure follow-up of pharmacist recommendations.
• Interact with providers or caregivers to schedule CMRs for qualifying members (i.e. cognitively impaired)
• Manage peer review cases including documentation of cases and summary of results.
• Manage pharmacy benefit questions for internal stakeholders and work identified issues to resolution.
• Quality Check reports prior to submission to CMS; review reports from Vendor(s) and ensure accuracy and completion for CMS