Representative, Medication Therapy Management Services (Remote)(Bilingual)

Molina Healthcare • Sterling Heights, MI • 13h ago

JOB DESCRIPTION

Job Summary

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) 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 with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met.

Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence.

Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations.

Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated.

Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required.

Utilizes appropriate resources to ensure member contact information is current and up-to-date.

Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members.

Interacts with appropriate primary care providers to ensure member registry is current and accurate.

Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation.

Proactively identifies ways to improve member relations.

Supports goal to achieve and maintain industry-leading Medicare STAR ratings.

Required Qualifications

At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience.

Excellent customer service skills.

Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc.

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, including excellent phone etiquette.

Microsoft Office suite, and applicable software program(s) proficiency.

Preferred Qualifications

Health care industry experience.

Pharmacy related experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

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.

Similar Jobs

Senior Ancillary Benefits Analyst - Employee Health & Benefits

MMC • Troy, MI • 8h ago

Hospital & Medical

Senior Ancillary Benefits Analyst - Employee Health & Benefits Our not-so-secret sauce. Award-winning, inclusive, Top Workplace culture doesn't happen overnight. It's a result of hard work by extraordinary people. Th...

8h ago

Go to Apply

Vetco Veterinarian Assistant

PETCO ANIMAL SUPPLIES STORES INC • Lake Orion, MI • 10h ago

Hospital & Medical

Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an exciting career path, feel welcome to be your whole self and nurture your wellbeing, Petco is the pla...

10h ago

Go to Apply

Outpatient Professional Coder/Full Time/Remote-Michigan Residents

Henry Ford Health System • Detroit, MI • 11h ago

Hospital & Medical

Using established coding principles and procedures, reviews, analyzes and codes diagnostic and/or procedural information from the patients medical record for reimbursement/billing purposes. Accurately abstracts informati...

11h ago

Go to Apply

Representative, Medication Therapy Management Services (Remote)(Bilingual)

Molina Healthcare • Detroit, MI • 13h ago

Hospital & Medical

JOB DESCRIPTION Job Summary Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy...

13h ago

Go to Apply

Henry Ford Health System • Detroit, MI • 13h ago

Hospital & Medical

GENERAL SUMMARY: The Specialist, Public Relations & Communications supports strategic communications and engagement efforts to support hospital campuses, medical centers and other regionally based services. Committed...

13h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.