Representative, Medication Therapy Management Services (Remote)(Bilingual)			
		Molina Healthcare
			
			
						
			
				JOB DESCRIPTION
  
  
**Job Summary**
  
  
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.
  
  
**Required 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.
  
  
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
  
  
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
  
  
Pay Range: $21.16 - $28.82 / HOURLY
  
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. 
 			
			
			
			
			
			
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