Pharmacy Care Coordinator

7 days ago


San Antonio, Texas, United States Optum Full time
About Optum
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. Our mission is to make the health system work better for everyone.

We believe in diversity and inclusion, which creates a healthier atmosphere. UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer.

About the Role
$1,000 Sign On Bonus Available for External Applicants
As a Pharmacy Care Coordinator at Optum, you will be responsible for making outbound calls to members and physicians to improve medication adherence and other pharmacy related quality metrics.

Your primary responsibilities will include conducting a high volume of outbound calls to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers.

You may also answer inbound calls from members and assist them with their inquiries. You will follow system scripting and validate member demographic information, document the provider or member's record with accurate information obtained on the call,

and perform desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate.

You will provide support to internal staff, subcontractors and providers with respect to Medicare drug related issues, participate in and contribute to the overall pharmacy quality improvement initiatives,

collect and maintain eligibility information in an appropriate and confidential manner, enter all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly,

exhibit excellent phone and communication skills while providing complete and accurate information to members, request additional or supplemental information via correspondence in order to complete applications,

adhere to assigned schedule and quality metrics, use a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders, follow all policy and procedures for the Medical Assistance Program,

and perform all other related duties as assigned.

Requirements
We require a High School Diploma / GED (or higher), Active and unrestricted Pharmacy Technician license in the state of Texas, National Pharmacy Technician Certification (Certified Pharmacy Technician CPhT),

1+ years of experience in a customer service setting, 6+ months of previous call center experience, basic level of proficiency with Medicare Part D, particularly the pharmacy record review, claims, billing and reimbursement rules,

basic level of proficiency with HIPAA Privacy and Security Rules and CMS security requirements, basic level of proficiency with writing skills and ability to produce work free from typographical or spelling errors, basic level of proficiency with Microsoft Office, Internet and e-mail including the ability to produce work free from typos,

and ability to sit for extended periods of time. A bilingual candidate would be preferred. The salary range for this role is $45,000 - $65,000 per year based on experience.

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