Pharmacy Member Outreach Rep

Universal Hospital Services Inc.; McAllen (TX); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Challenging and rewarding work

Competitive Compensation & Generous P0

Medical, Dental, Vision and Rx plans

401(K) with company match

SoFi Student Loan Refinancing

Career development opportunities

Job summary

Prominence Health seeks a motivated and patient case-focused individual to join our Member Outreach Pharmacy Team. The Member Outreach Pharmacy Representative serves as the liaison between Prominence Health Plan, its members, and contracted providers, contacting members by phone to educate them on health insurance offerings and services while addressing inquiries and supporting quality improvement.

The role also leads care-gap resolution during telephonic outreach and helps develop the outreach

Qualifications

• High School diploma or equivalent required.
• Current and valid state pharmacy technician license preferred.
• PTCB license preferred.
• 3+ years of outbound calls to members or patients preferred.
• 3+ years in retail/community pharmacy preferred.
• Exceptional customer service over the phone.
• Understanding of health plan departments and problem resolution.
• Knowledge of current state pharmacy dispensing laws.
• Strong data tracking and performance management skills.
• Fluent English; Spanish proficiency preferred.

Responsibilities

• Liaise between Prominence Health Plan, members, and providers by phone.
• Inform and educate members on health insurance offerings and services.
• Respond to inquiries and assist with quality improvement initiatives.
• Lead efforts to resolve drug-related care gaps during outreach.
• Develop outreach program and serve as primary education/technical contact.

Skills

Customer service

Outbound calling

Verbal communication

Spanish language

Problem solving

Attention to detail

Analytical skills

Team collaboration

Education

High School diploma

State pharmacy technician license preferred

PTCB license preferred

Tools

Excel

Adobe

Word

Outlook

Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary

Prominence Health seeks a motivated and patient case-focused individual to join our Member Outreach Pharmacy Team. The Member Outreach Pharmacy Representative is the liaison between Prominence Health Plan, its members, and contracted providers. The main focus of this position is contacting Prominence Health Plan members by phone to inform and educate them on the health insurance offerings, products, or services, as well as respond to inquiries and assist with quality improvement. In addition, this individual will serve as a lead to resolve drug-related care gaps during telephonic member outreaches. This individual also facilitates the development of the outreach program and serves as the primary contact, offering education, technical assistance, and problem solving as necessary. By performing outreach activities, the Member Outreach Specialist will identify quality insufficiencies and consult with the department and company's leaders on quality improvement initiatives and outcomes.

Benefit Highlights

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

Qualifications and Requirements

• High School diploma or equivalent required
• Current and valid state licensure as a pharmacy technician is preferred
• Current PTCB license preferred
• 3+ years' experience in making outbound calls to members and or patients preferred
• 3+ years' in retail/community pharmacy preferred
• Exceptional customer service skills, serving patient needs over the phone.
• Understanding of health plan departments and functional areas for problem resolution
• Understanding of current state laws pertaining to pharmacy dispensing
• Comfortable collecting and tracking performance metrics and managing the team to certain performance expectations
• Strong analytical skills
• Attention to detail
• High level of energy
• Good computer skills (Excel, Adobe, Word, Outlook, etc.)
• Language Skills: Ability to effectively communicate in English, both verbally and in writing. Written and oral fluency in Spanish is preferred
• Utilizing sound drug knowledge to assist patient questions over the phone effectively
• Knowledge of medical terminology

Skills

• A positive attitude is a must.
• Proficient in Microsoft Office skills.
• Enjoys working in both individual and team settings
• Problem solver – enjoys problem-solving
• Self-starter, resourceful, and able to execute projects in a fluid and fast-paced environment
• Good communication and relationship skills
• Strong analytical skills
• Attention to detail
• High level of energy
• Ability to utilize technology and work within multiple software programs
• Exceptional customer service skills, serving patient needs over the phone.
• Understanding of health plan departments and functional areas for problem resolution
• Understanding of current state laws pertaining to pharmacy dispensing
• Comfortable collecting and tracking performance metrics and managing the team to certain performance expectations

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.