[Hiring] Representative, Medication Therapy Management Services @Molina Healthcare

Role Description

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.

• 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.

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.

Benefits

Molina Healthcare offers a competitive benefits and compensation package.

Company Description

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.