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

Molina Healthcare; Grand Rapids (MI); Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare organization in Grand Rapids is seeking a MTM Pharmacy Service Representative to manage pharmacy benefit programs and assist members with their needs. Responsibilities include handling pharmacy calls, ensuring compliance with regulations, and supporting pharmacy staff. Ideal candidates will have a high school diploma, 1-3 years of customer service experience, and strong communication skills. This role offers competitive hourly pay and a supportive work environment.

Benefits

Competitive benefits and compensation

Qualifications

• 1-3 years of call center or customer service experience required.
• Strong verbal and written skills and excellent phone etiquette.
• Ability to work independently on special projects.

Responsibilities

• Handle inbound/outbound pharmacy calls from members and providers.
• Provide support to pharmacists and technicians with day-to-day operations.
• Communicate general Medicare and Medicaid benefits to members.

Skills

Call center experience

Customer service skills

Verbal and written communication

Proficiency in Microsoft Office

Education

High School Diploma or equivalency

Associate's Degree (preferred)

Job description

Job Description

Job Summary

Molina Pharmacy Services/Management staff work to ensure that Molina members, providers, and pharmacies have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan’s pharmacy benefit programs in accordance with all federal and state laws.

The MTM Pharmacy Service Representative is responsible for performing outreach attempts and handle inbound calls for our Molina Healthcare members. Duties include, but are not limited to, transferring members to internal departments for medication reviews, scheduling appointments, and acting as a liaison between other departments.

Job Duties

• Handles and records inbound/outbound pharmacy calls in required systems from members, providers, pharmacists, pharmacies, and technicians to meet departmental and CMS standards.
• Enforce HIPAA compliance standards and regulations while maintaining guidelines and other necessary information for our providers, members, technicians and pharmacists.
• Provides clerical services and support to the pharmacist and technicians staff with day-to-day operations as delegated.
• Follow policies and procedures for appropriate call resolution or transfer to internal departments as required
• Utilize appropriate resources to ensure members contact information is current and up to date.
• Effectively communicate general Medicare and Medicaid plan benefits to existing members.
• Interact with appropriate primary care providers to ensure patient registry is current and accurate.
• Support pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation.
• Proactively identify ways to improve member relations.

Job Qualifications

REQUIRED EDUCATION :

High School Diploma or equivalency

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 1-3 years of call center or customer service experience
• Excellent customer service skills
• Ability to work independently when assigned special projects, such as pill box requests, CM referrals, OTC requests, etc.
• Strong verbal and written skills and excellent phone etiquette
• Ability to multi-task applications while speaking with members
• Proficient in using Microsoft Office programs (Word, Excel, MS Teams, and Outlook)

PREFERRED EDUCATION :

Associate's Degree

PREFERRED EXPERIENCE :

3-5 years; healthcare industry experience preferred

Bilingual preferred

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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.