1+ months

Pharmacy Support Specialist - 915971

Houston, TX 77002
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  • Job Code
    915971

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)

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The Pharmacy Support Specialist will make outbound calls to members and physicians to improve medication adherence and other pharmacy related quality metrics. Responsible for gathering prescription refill orders and providing excellent customer service as well as determining the eligibility of members applying for the Medical Assistance Program. May serve as a subject matter expert for the Pharmacy team.

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Primary Responsibilities:

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  • Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and / or obtain important follow up information from providers (Outbound calls are made primarily using an auto dialer requiring precision to detail and adaptability to type of response needed)
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  • May answer inbound calls from members and assists them with their inquiries - Route calls to appropriate department if necessary
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  • Follow system scripting and validates member demographic information
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  • Document the provider or member's record with accurate information obtained on the call
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  • 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
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  • Provide support to internal staff, subcontractors and providers with respect to Medicare drug related issues
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  • May serve as a subject matter expert for the Pharmacy team and mentor new employees to the team as necessary
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  • Participate in and contributeto the overall pharmacy quality improvement initiative.
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  • Collect and maintain eligibility information in an appropriate and confidential manner
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  • Enter all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly
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  • Exhibit excellent phone and communication skills while providing complete and accurate information to members
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  • Request additional or supplemental information via correspondence in order to complete applications
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  • Adhere to assigned schedule and quality metrics
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  • Use a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders
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  • Follow all policy and procedures for the Medical Assistance Program
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You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

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Required Qualifications:

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  • Certified Pharmacy Technician (CPhT)
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  • High School Diploma or GED
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  • 2+ years of experience in a pharmacy setting with an additional 1+ years of experience in a customer service setting
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  • Extensive knowledge of the Medicare Part D, particularly the pharmacy record review, claims, billing and reimbursement rules
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  • Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
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  • General writing skills and ability to produce work free from typographical or spelling errors
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  • Advanced knowledge of NCPDP and other types of prescription drug claims
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  • Working knowledge of Microsoft Office, Internet and e-mail
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
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Preferred Qualifications:

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  • Bilingual
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  • PBM experience
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  • Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies
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  • Previous retail pharmacy experience
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  • Previous Call Center experience
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Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment 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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords:Pharmacy Technician, CPT, Pharmacy Support, Part D, WellMed, Houston, Northwest Houston, TX, Texas

Posted: 2021-04-29 Expires: 2021-06-30

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Pharmacy Support Specialist - 915971

UnitedHealth Group
Houston, TX 77002

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