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Pharmacy Care Technician - San Antonio, TX

Company: Optum
Location: Cibolo
Posted on: June 30, 2024

Job Description:

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start -Caring. Connecting. Growing together. -
The -Pharmacy Care Technician -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.
Schedule: Monday to Friday 9:00am to 6:00pm CST with rotating Saturday's from 8:00am to 5:00pm CST
Location: Onsite - -19500 W Interstate 10, San Antonio, Texas, 78257
Primary Responsibilities: -

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
May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary
Follows system scripting and validates member demographic information
Documents the provider or member's record with accurate information obtained on the call
Performs desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate
Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues
May serve as a subject matter expert for the Pharmacy team and mentor new employees to the team as necessary
Participates in and contributes to the overall pharmacy quality improvement initiatives
Collects and maintains eligibility information in an appropriate and confidential manner
Enters all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly
Exhibits excellent phone and communication skills while providing complete and accurate information to members
Requests additional or supplemental information via correspondence in order to complete applications
Adheres to assigned schedule and quality metrics
Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders
Follows all policy and procedures for the Medical Assistance Program
Performs all other related duties as assigned

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.Required Qualifications: -

High School Diploma / GED -(or higher)
Certified Pharmacy Technician (CPhT) in the state of Texas
National Pharmacy Technician Certification
2+ years of experience in a pharmacy setting -
1+ years of experience in a customer service setting
1+ years of experience with knowledge of Medicare Part D, particularly the pharmacy record review, claims, billing, and reimbursement rules -
1+ years of experience with working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
1+ years of experience with working knowledge of Microsoft Office, internet, and e-mail
1+ years of demonstrated general writing skills and ability to produce work free from typographical or spelling errors

Preferred Qualifications: -

Call Center experience
PBM experience -
Advanced knowledge of NCPDP and other types of prescription drug claims
Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies. Retail pharmacy experience
Bilingual - -

**PLEASE NOTE** The sign-on bonus is only available to external candidates. - Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. -
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
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.
UnitedHealth Group -is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO, #Red

Keywords: Optum, New Braunfels , Pharmacy Care Technician - San Antonio, TX, Professions , Cibolo, Texas

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