Pharmacy Provider Specialist

Location

Mcallen, TX | United States

Job description

Responsibilities

Job Summary: The Pharmacy Provider Specialist will serve as a liaison to medical practice groups and to provide administrative and clinical support in closing gaps in pharmaceutical care such as medication nonadherence. In tandem with other Prominence representatives, this position will develop relationships with medical practice groups and serve as their subject matter expert on pharmacy benefits. Will interface with members thru home visits and telephonically and with pharmacies to support internal departments to improve performance in the organization’s Star Rating program. This position will resolve member-level barriers to medication nonadherence and provide member-level and provider-level solutions to close gaps in care. Will perform other duties as needed related to coordination with medical provider practice groups.

Qualification Requirements:

1. Education/Licensure:
   1. High school diploma or equivalent (required)
   2. Associates degree or equivalent work experience (preferred)
   3. Active pharmacy technician license or medical assistant license (required)
2. Preferred Background/Experience
   1. 2+ years of prior health care experience at a Medicare Advantage plan (highly preferred)
   2. 2+ years of previous experience working with retail pharmacy or provider office (highly preferred)

Language Skills:

• Ability to effectively communicate in English, both verbally and in writing.
• Bilingual in English and Spanish is preferred

Preferred Skills/Knowledge:

• Excellent phone and face-to-face interpersonal skills, written communication skills, and public speaking skills
• Excellent and organized communications skills with members, medical provider office staff, and pharmacy staff
• Inclination towards being persistent and determined in achieving goals and obtaining responses from external provider office partners
• Excellent organizational skills when handling large amount of data and ability to present such data in an understandable way
• Understanding of retail pharmacy and/or medical provider front office/administrative operations
• Familiarity with the pharmaceutical, managed care, and PBM industries
• Strong processes improvement skills necessary to get things done
• Knowledge of State and Federal regulations as they pertain to the health insurance industry.
• Experience with STAR ratings and care cap reports
• Knowledge of Medicare Advantage & HMO contracts
• Previous experience reviewing and analyzing statistical data to identify trends as well as potential problems/opportunities for improved service quality.
• Familiarity with and ability to quickly learn multiple software tools
• Ability to manage multiple priorities simultaneously and effectively.
• Intermediate level MS Office skills, include MS Excel

Location and Travel Demands:

• Willingness to relocate to McAllen, TX or surrounding areas if currently not residing in this area
• Flexibility to work remotely with willingness to travel to provider offices and other areas within Laredo TX, McAllen TX, and their surrounding areas when needed
• Willingness to occasionally travel when needed to other states with Prominence Health Plan membership

Physical Demands:

• For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.

Location and Travel Demands:

• Potential for fully remote position
• Occasional travel to Reno, NV may be required for on-site trainings, in-person meetings with providers, or other health plan needs

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.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries.  We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: or 1-800-852-3449 .

Job tags

Salary