Member Advocate - Pharmacy

Responsibilities

• Complete timely and accurate documentation of contacts and outcomes in referral platform.
• Performs research to identify appropriate community resources and maintains information of available resources to meet various member needs.
• Directs members on how to apply for low-income subsidy for Medicare Part D.
• Prioritizes assignments appropriately and maintains flexibility as new priorities arise.
• Promotes communications, both internally and externally, to enhance effectiveness of pharmacy services for membership.
• Strives to improve quality in all areas of responsibility and cooperate with all departments to improve quality throughout The Health Plan.
• Ensures that all financial assistance applications are processed timely and accurately.
• Provides excellent customer service to members and providers.
• Consults with clinical pharmacists for guidance and assist if necessary.
• Gathers clinical documentation necessary for the performance of medication reconciliation and yearly medication reviews and refers documentation to a Care Management Pharmacist for review if needed.
• Works DSNP IR referrals for diabetic and nebulizer testing supplies.
• Back-up for ACD lines and completes medication coverage requests during peak seasons and if short staffed.
• Maintains compliance with all plan policies and procedures.

Qualifications

• Undergraduate degree in health-related field preferred.
• One year experience in a retail, hospital, managed care, or other similar pharmacy setting.
• Knowledge of pharmaceutical generic and trade names.
• Strong organizational skills, time management and multi-tasking abilities.
• Detail oriented with advanced analytical and problem-solving skills.
• Ability to work effectively as part of a team and independently.
• Effective oral and written communication skills, including grammar and spelling.
• Knowledge of direct claims processing, pharmacy computer systems, spreadsheet applications (i.e., Microsoft Excel), phone system and other office/computer equipment as required.

Benefits

• 8:00am - 5:00pm
• 40 hours per week

Schedule

• 8:00am - 5:00pm

Pay

• Negotiable based on experience and qualifications.