Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm) The Associate Pharmacy Care Coordinator will effectively support the successful implementation and execution of all pharmacy programs and processes. This position will provide support to the pharmacy staff to ensure applicable program processes and operational responsibilities are met. The Associate Pharmacy Care Coordinator will be responsible for determining eligibility of members applying for the Medical Assistance Program (MAP). This position will also provide support in troubleshooting any member issues identified by the pharmacy staff during member outreach calls. Primary Responsibilities:
Receives and responds to escalated pharmacy inquiries from all communication venues: e.g. phone queue, portal, claim queue, department e-mail box or fax Coordinates and assists initial screening of MAP enrollment requests via all communication venues; as well as administrative preparation for clinical staff Conducts in-bound and out-bound calls for program requirements including, but not limited to: patient scheduling, surveys/screenings, reminder calls, census management and distribution of materials to appropriate clinical personnel or patients Initiates the process of granting, modifying, denying, or terminating assistance, or referring applicants to other agencies for assistance Collects and maintains eligibility information in an appropriate and confidential manner Interviews applicants by phone for program requirements 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 customers 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 Maintains abreast of program qualifications in order to troubleshoot problems that may arise during the eligibility process Completes calls/assignments and ensures census management, productivity weekly and monthly standards are met Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports Provides excellent customer service by serving as a resource to all internal and external customers Attends required meetings and participates in special committees as needed Comply with all organizational policies regarding ethical business practices Adhere to all department policies and procedures Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times Maintain strict confidentiality at all times to include but limited to patients and coworkers Comply with all organizational policies regarding ethical business practices Adhere to all department policies and procedures Performs other duties as assigned
Hours: M-F rotate 8am-5pm or 9am-6pm Sat. 9am-1pm every 12 weeks
High School Diploma or GED 2 years of administrative support experience 6 months experience in a medical setting Basic knowledge of Microsoft Office products, including Word and Outlook Medical terminology knowledge base
Ability to work independently, with some supervision and direction from manager
Demonstrate excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers
Certified Medical Assistant training or certification 2 years of experience in a physicians clinic or hospital Bilingual language proficiency (English/Spanish)
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000 lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the **MEMBERS ONLY**SIGN UP NOW***. family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: **MEMBERS ONLY**SIGN UP NOW***. 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.
**MEMBERS ONLY**SIGN UP NOW***. is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: customer service, call center, intake, prior authorization, medical assistant, administrative, clerical, coordinator, claims, San Antonio, TX, Texas
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