Representative, Medication Therapy Management Services (Remote)(Bilingual)

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

Preferred Qualifications

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