Job Description
Position Summary Responsible for assisting the organization, pharmacists, care managers, primary care providers and external partners in the management of the member's needs related to medications.
Essential Functions - Utilize Care Management documentation platform to assist in Care Management of members
- Support and assist Care Management team with the medication management process by collecting and verifying medication lists from pharmacy claims data or pharmacies, primary care practice records, member interviews, discharge summaries, and other sources as necessary in preparation for medication reconciliation/ medication review
- Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
- Provide best practice population health services to identified members with specific medication management needs
- Assist members, providers, and organizational staff with medication access issues such as prior authorization requests or other information as needed
- Assist with transmitting Care Management team recommendations to medical home providers, using provider-preferred method of communication; receive and accurately document medical home provider responses to recommendations
- Engage and maintain relationships with community pharmacies and external partners
- Assist with fielding questions and maintaining communication between Care Management team, primary care and specialty providers, and others to promote continuity of member care
- Assist with coordination, implementation and ongoing management of pharmacy initiatives across all business lines that promote evidence-based and cost-effective prescribing such as payer drug policy education and medication related quality and practice transformation initiatives
- Adhere to CCNC privacy and security policies to ensure that patient and company data are properly safeguarded
Qualifications - Completion of Pharmacy Technician Program required
- Certified Pharmacy Technician (CPhT) and registered with NC Board of Pharmacy preferred
- A minimum of 2 years of relevant pharmacy experience
- Maintain ability to gain and keep access to Hospital/Data or Electronic Medical Record systems
- Maintain a valid NC driver's license with current auto liability insurance
Knowledge, Skills, and Abilities - Strong knowledge of the Care Management documentation platform
- Computer skills required including various office software and the internet; experience with MS Office software preferred
- Experience in patient or clinical data systems
- Knowledge of and experience with federal and state regulations governing prescription medications and pharmacy operations
- Analytical skills necessary as independent decisions and problem solving are required
- Excellent interpersonal communication skills
- Sensitivity to diversity of cultures, language barriers, health literacy and educational levels
- Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
- Able to shift strategy or approach in response to the demands of a situation
Working Conditions - "Hands-on" clinical treatment or counseling/psychotherapy is NOT permitted when performing duties for the organization
- Multiple contacts are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur
- Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time
- Must be able to utilize office equipment, computer, keyboard and phone with or without assistive devices
- Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds
- Travel will be required within the region and/or the State
The above statements are intended to describe the general nature and level of work performed in this position and are not to be construed as an all-inclusive list of duties, skills and responsibilities. In signing this job description, I confirm that I understand and am able to fulfill the terms of the position as set forth above.
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