• Coordinate and process medication refills, including data entry and claim adjudication • Place outbound refill calls and assist patients through the refill request • Respond to and resolve inbound patient and provider inquiries • Clarify prescription orders with pharmacists or clinical staff • Maintain and update patient and prescription data in software systems • Spot trends, recommend improvements, and support process-improvement initiatives • Partner with cross-functional teams to deliver a seamless patient experience • Maintain confidentiality and uphold high-quality service standards

• Provide telephonic and/or video and/or SMS-based outreach, engagement, and education of vulnerable patients in the Medicaid program in California. • Work with a multidisciplinary team to provide care management services that ‘wrap around’ primary care provider practices; team members include Community Health Workers, Care Coordinators, and Behavioral Health Therapists. • Support patients and providers around transitions of care. • Provide clinical services that support day-to-day operations and safe practices of the program. • Participate in QI activities to assure quality, cost-effectiveness, and ROI. • Utilize analytics dashboards that help you proactively outreach patients who receive medication and/or equipment rejections, admissions/readmissions, or who may benefit from medication adherence counseling. • Lead and mentor pharmacists and/or pharmacy technicians.

Role Description As a Patient Engagement Specialist, you will help patients manage their medications. You will answer calls, make refill calls, and guide patients through the refill process. You’ll work closely with pharmacists, providers, and care teams to make sure patients get the support they need. What You’ll Do: - Answer inbound and/or outbound patient and pharmacy calls - Call patients to schedule and complete medication refills - Help process prescriptions and resolve claim issues - Check prescription status and update patient records - Work with pharmacists and providers to clarify orders - Provide friendly, helpful support to patients and partners - Use systems to track work and keep information up to date - Other duties and/or responsibilities may apply Qualifications - Pharmacy Technician experience (1–3 years preferred) - High school diploma or GED - Pharmacy Technician state registration (required where applicable) - National certification (CPhT/PTCB) required - Knowledge of prescription processing or claims adjudication (preferred) - Strong communication and phone skills - Comfortable speaking with patients and care teams daily - Organized, detail-oriented, and dependable - Able to learn new systems quickly Requirements - Remote role (must have reliable high-speed internet and a quiet workspace) - Two monitors required (provided by company) - Monday–Friday schedule, may start as early as 7:45 AM EST - Occasional overtime may be needed Benefits - Medical - Dental - Vision - 401(k) with company match - Paid Holidays - Paid Time Off - Paid Parental Leave - And more

Role Description The Pharmacy Technician is responsible for supporting the clinical and operational processes for Star measures within Medicare. This includes: - Making outreach to providers and pharmacies to assist medication adherence interventions by promoting program benefits with Medicare Part D members. - Interacting with BCBSM staff pharmacists, interns, and pharmacy students. - Assisting in maintaining call logs and database notes for Medicare membership. - Monitoring voicemailbox and facilitating responses. - Taking inbound customer service calls. - Creating comprehensive medication lists for professional staff. - Researching, analyzing, identifying, and evaluating data from assigned problems to evaluate existing issues. - Maintaining comprehensive knowledge of government business, products, programs including provider data, networks, etc., and corporate organizational structure. - Assisting leadership by investigating, reviewing, and recommending innovative solutions which identify problems/root causes of issues. - Documenting feedback between corporate business areas and participating in group or committee discussions. - Effectively communicating to upper management calls that require escalation. Qualifications - High School Graduate or GED equivalent required; Associate’s degree preferred. - Active unrestricted Pharmacy Technician License or Pharmacy Technician Certification (PTCB) Required. - At least one (1) year experience in retail, hospital, or managed care Pharmacy preferred. - Knowledge of pharmacy claims processing; working knowledge of Medicare Part D is preferred. - Excellent customer service and communication skills. - Ability to make competent, independent decisions. - Ability and proficiency in the use of computers and Company standard software specific to position. - High level of proficiency with Microsoft Office products. - Strong ability to work independently, within a team environment, and communicate effectively with employees and clients at all levels. - Ability to multi-task and shift priorities with ease to meet business needs. Requirements - All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability. - Candidates are hired on an "at will" basis. Nothing herein is intended to create a contract.