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Pharmacy, Associate, Pharmacy Specialist

Headquarters Office, 625 State Street, Schenectady, New York, United States of America; Rochester Office, 220 Alexander Street, Rochester, New York, United States of America Req #246
Monday, September 30, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.

   

Status: Full-time, Exempt: No 

Summary


This position will help licensed pharmacists take care of many of the daily operations of the pharmacy department. This is including, but not limited to: calling providers, members, and pharmacies; having knowledge of pharmacy benefits for MVP’s multiple lines of business, formularies, and policies; providing drug-related information to Customer Care Center and other internal departments; managing incoming faxes requesting drug coverage; determining eligibility and evaluating pre-authorization requirements using multiple systems; obtaining additional information and initiating cases for review when appropriate for multiple lines of business; preparing cases for review by Pharmacists; requesting additional clinical information for case completion from provider via verbal and fax requests; completing case files by creating member/provider written notifications and making outgoing calls to provide members/providers with determinations; creating and monitoring timeframe activity reports at least daily or more frequently as applicable and escalating cases with impending timeframes; ensures that regulatory timeframes are met using learned knowledge and daily tracking; creating and maintaining reports using MS Excel, Access, and other reporting tools; loading different types of authorizations and testing for accuracy; supporting the Medicare MTM program by utilizing communication skills such as motivational interviewing to gain agreement from members to participate in comprehensive medication reviews (CMR); perform special projects, and is cross-trained in selected functions, as assigned. Rotating weekend work and evening work may be required.

 


POSITION QUALIFICATIONS


Minimum Education:


  • AAS degree preferred or equivalent combination of education and experience required.

  • Completion of Pharmacy Technician course preferred.

Minimum Experience:

  • 1-2 years of data entry experience

  • 1-2 years of customer service experience resolving complex customer inquiries

  • Related to required minimum experience above, relevant insurance, medical or healthcare experience involving prescription medication services is highly preferred

      

    Required Skills:

  • Strong written and verbal communication skills using different tools (email, fax, phone, etc.)

  • Strong data entry skills with superior attention to detail

  • Moderate to strong computer literacy with proficiency in MS Word, Excel, and Outlook

  • Flexibility to adapt to changing environment and/or workflow processes on a day-to-day basis

  • Ability to excel in a fast-paced, deadline-oriented position using superb time management skills

  • Ability to work independently in a team environment with desire to help others

  • Maintains professional approach in workplace with strong interpersonal skills.

  • Strong desire to learn, improve and adhere to complex processes as defined

  • Excellent customer service skills and ability to deal with stressful calls in a professional manner

  • Familiarity with healthcare benefits, pharmacy and medical terminology

  • Previous experience requiring strict adherence to confidentiality

  • Ability to sit at workstation for long periods of time in front of computer

  • Ability to multi-task using multiple computer systems and prioritize work #ZIP


MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

Other details

  • Job Family Pharmacy
  • Pay Type Hourly
  • Headquarters Office, 625 State Street, Schenectady, New York, United States of America
  • Rochester Office, 220 Alexander Street, Rochester, New York, United States of America