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Pharmacy Care Associate Technician

2 months ago


Pipe Creek, Texas, United States Optum Full time
Sign-On Bonus: $1,000 for External Applicants

Company Overview:
Optum is a leading global organization dedicated to enhancing healthcare through innovative technology. Our mission is to support millions in achieving healthier lives. The contributions you make will directly influence health outcomes by connecting individuals with essential care, pharmacy benefits, data, and resources. Our culture is rooted in diversity and inclusion, featuring talented colleagues, comprehensive benefits, and ample opportunities for career growth.

Position Overview:
The Pharmacy Care Associate Technician will engage in proactive outreach to members and healthcare providers to enhance medication adherence and improve pharmacy-related quality metrics.

Key Responsibilities:
  • Conduct a significant volume of outbound communications to members to address non-compliance with medications, schedule pharmacy consultations, and gather essential follow-up information from healthcare providers.
  • Utilize an autodialer for outbound calls, requiring attention to detail and adaptability to various responses.
  • Handle inbound inquiries from members, providing assistance and routing calls to the appropriate departments as necessary.
  • Follow established scripts and verify member demographic information during calls.
  • Document accurate information in member or provider records based on call interactions.
  • Review claims documentation to ensure correct billing and appropriate payments to pharmacies.
  • Support internal staff and providers with Medicare-related inquiries.
  • Participate in pharmacy quality improvement initiatives.
  • Maintain confidentiality while collecting and managing eligibility information.
  • Meet deadlines for application processing to ensure eligibility requirements are satisfied.
  • Exhibit excellent communication skills while delivering accurate information to members.
  • Request additional information as needed to complete applications.
  • Adhere to scheduled hours and quality metrics.
  • Utilize a multi-line phone system to manage calls regarding eligibility and medication refills.
  • Comply with all policies and procedures related to the Medical Assistance Program.
  • Perform other related duties as assigned.

Required Qualifications:
  • High School Diploma or GED (or higher).
  • Active and unrestricted Pharmacy Technician license in Texas.
  • National Pharmacy Technician Certification (CPhT).
  • Minimum of 1 year of experience in a pharmacy environment.
  • Minimum of 1 year of experience in customer service.
  • At least 6 months of call center experience.
  • Basic understanding of Medicare Part D, including pharmacy record review and claims processes.
  • Familiarity with HIPAA Privacy and Security Rules.
  • Proficient writing skills with attention to detail.
  • Basic proficiency in Microsoft Office, internet, and email.

Preferred Qualifications:
  • Bilingual candidates are encouraged to apply.
  • Experience with Pharmacy Benefit Management (PBM).
  • Advanced knowledge of NCPDP and prescription drug claims.
  • Understanding of Medicare Part B and Part D coverage guidelines.
  • Previous experience in retail pharmacy.

Commitment to Diversity:
Optum is an Equal Employment Opportunity / Affirmative Action employer. We value diversity and encourage all qualified applicants to apply without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.