Molina Healthcare is a Fortune 500 managed care company with a storied history that dates back to 1980 and the opening of a medical clinic by Dr. C. David Molina. As an employer, M
CSR Medication Therapy Management Services
Location
MST (UTC-7)
Posted
10 hours ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
CSR Medication Therapy Management Services
Molina Healthcare
Role Description Molina Healthcare is hiring for a CSR for our Medication Therapy Management department. This role will be working Monday through Friday 10am to 630pm Mountain Standard Time. 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. 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.
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