Pharmacy Quality Specialist

Blue Cross and Blue Shield of North Carolina

1d • Hybrid

About The Position

We're seeking a Pharmacy Quality Specialist to join our team! The Pharmacy Quality Specialist will provide assistance to Pharmacists and/or Advanced Practice Clinicians to support Medication Therapy Management (MTM) and quality programs. The Pharmacy Quality Specialist will complete outreach calls to eligible health plan members and/or caregivers to introduce and explain the MTM benefit, verify and obtain demographic and medication-related information, schedule appointments for the MTM Pharmacist to complete the comprehensive medication review or target intervention. This position will also support Medicare Star and other quality initiatives. Note: The designated shift will be 10 AM - 7 PM EST (Monday - Friday)

Requirements

• High school diploma or GED
• 3+ years of experience in related field.
• Active pharmacy technician license in the state of North Carolina (PTCB: Pharmacy Technician Certification Board - Nationally Accredited Certification Exam), preferred.

Nice To Haves

• Strong customer service skills with demonstrated ability to engage with patients and health plan members in a professional and empathetic manner.
• Excellent communication skills tailored to customer, patient, and member needs.

Responsibilities

• Verify member demographic information, provider and pharmacy contact information and enter into the MTM platform as needed
• Contact members to introduce and explain the benefits of the MTM program and follow up as needed and to schedule appointments for the MTM Pharmacist to complete the Comprehensive Medication Review or the Targeted Intervention
• Receive and respond to calls from provider offices, members and pharmacies; make determinations of appropriate action required from calls and escalate calls as needed
• Coordinate outbound faxing and subsequent follow-up calls with health care providers
• Assess and interprets member needs and requirements, triaging to a clinical pharmacist or other areas when appropriate
• Support Medicare Star and other quality initiatives

Benefits

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
• Work-life balance, flexibility, and the autonomy to do great work
• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees