Pharm Outreach Specialist

General Summary

The pharmacy outreach specialist plays an integral role by assisting patients in adhering to their medication regiment and by coordinating with pharmacies in distributing medication to patients. This position on the central quality initiatives team will act as a liaison between patient, provider, and pharmacy to promote medication adherence and improve pharmacy quality measures, specifically the Part D STARS measures proportion of days covered (PDC).

Responsibilities

• Assists patients in adhering to their medication regiment and assists clinicians and pharmacies in distributing medication to patients.
• Responsible for pursuing new medications and/or refills for our patients by completing telephonic outreach to patients to identify and address medication adherence barriers.
• Pursues medications for our patients by faxes, calling doctors, and calling our patients.
• Works in a call-oriented, repetitive, and fast-paced environment.
• Helps patients receive their medications, contributing to their adherence and health.
• Reaches and maintains productivity and quality metrics.
• Aids in developing logic to target highest priority patients for outreach.
• Contact prescriber offices via telephone in pursuit of medication.
• Contact patients via telephone and text in pursuit of medication.
• Provides one call resolution on all calls.
• Maintains a high level of professionalism when speaking with patients, providers, and other employees.
• Keeps lines of communication open with the team members to address potential issues that may arise.
• Conducts medication compliance calls to patients.
• Gathers and records appropriate member information in accordance with policies and procedures via telephone.
• Edits patients on the importance of medication adherence, formulary, medication resources or assistance programs.
• Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services.
• Records call details and utilizes call scripts as needed based on client requirements.
• Completes & coordinates medication refill with retail pharmacies, primary doctor, or other clinicians, as required.
• Contacts physician offices to obtain demographic information or related data as needed.
• Confirms patients' demographic information as necessary for mail order prescriptions.
• Transfers prescriptions as requested by patients or other pharmacies.
• Trips calls/voicemails, working to resolve any outstanding prescription issues, as appropriate.
• Directs member inquiries to appropriate clinical staff.
• Maintains record keeping and generates reports related to outreach, and other ad-hoc reports.
• Adheres to HIPAA requirements while contacting patients, providers, and other pharmacy staff.
• Applies excellent communication, customer service, and problem-solving skills to all interactions.

Qualifications

• High school diploma or equivalent
• Minimum of 3 years of experience in customer service or outreach demonstrating ability to influence customers/members
• Pharmacy Tech Certification, or Training required