Pharmacy Outreach Coordinator

Stellenbeschreibung:

Provide administrative support for pharmacy programs and projects designed to generate revenue, lower pharmacy spend, reduce member out-of-pocket costs, and improve quality metrics
Conduct provider, member, and pharmacy outreach for clinical programs, including therapeutic interchange and cost‑saving or quality‑improvement initiatives
Work closely with clinical and analytic staff
Analyze financial progress reports and prioritize tasks according to stakeholder expectations
Serve as an outpatient medication access specialist for local and out-of‑area members
Perform routine quality checks on system applications and functions
Recommend methods for documenting, tracking, and measuring information
Identify process inefficiencies, recommendation success rates, and systematic failures with key staff
Adopt new processes and procedure changes
Provide weekly updates to the department supervisor on assignments and provider outreach responses
Perform initial assessment of claims files and data extractions to identify outreach cases
Prepare and assist with patient and provider outreach for targeted programs
Produce statistics on attempted outreach and inbound inquiries
Protect member privacy and follow corporate privacy policies, procedures, Code of Conduct, and Lifetime Way values
Maintain regular and reliable attendance
Perform other functions assigned by management
Level II: inform leadership of program successes, challenges, and barriers and recommend solutions
Level II: suggest process improvements and participate in resolving complex issues
Level II: mentor junior staff and assist with coaching
Level II: manage weekly and monthly coordinator scheduling
Level II: support procedural changes and improve payer/provider relations
Level II: develop DLPs, speaking points, and educational tools
Level II: lead training for new coordinators on program goals, policies, procedures, and platform navigation
Level II: facilitate communication among coordinators, clinical pharmacists, and project management

Requirements

High school education required
Minimum of two years’ experience in a health-related field
Pharmacy Technician certification (CPhT) strongly preferred
Experience working in a doctor’s office, hospital, infusion center, pharmacy, or customer service strongly preferred
Basic understanding of drug classes and therapeutic interchange
Awareness of prescription and medical benefits as applied to utilization review and drug formularies desired but not required
Current clinical knowledge necessary for high-quality outreach encounters and intervention reconciliation
Strong written, verbal, and telephone communication skills
High degree of professionalism and strong work ethic
Ability to maintain a positive attitude with internal and external customers
Ability to handle large amounts of information accurately via spreadsheet or database
Strong customer service orientation
Ability to interface effectively with internal and external customers
Ability to work independently and apply problem‑solving and analytical abilities
Level II: minimum 2–3 years’ experience working with a health plan organization
Level II: basic understanding of medical terminology
Level II: clear understanding of prescription and medical drug benefits and benefit design impacts
Level II: proficiency with Excel, company platforms, and databases
Level II: ability to navigate the healthcare system, including vendor and facility relationships
Level II: ability to develop and refine techniques for responding to providers, pharmacies, and members
Level II: ability to mentor and train less experienced staff
Ability to travel across the Health Plan service region for meetings and/or trainings
Ability to work in a home office for continuous periods
Ability to work at a workstation using a computer, keyboard, mouse, and/or phone for three or more hours at a time
Ability to hear, understand, and speak clearly while using a phone

Core Competencies

Demonstrates expertise in pharmacy program administration, including outreach, quality improvement, and financial analysis. Proficient in mentoring staff and implementing process improvements while maintaining high standards of customer service and communication.