Note: The job is a remote job and is open to candidates in USA. Prime Therapeutics is a unique pharmacy benefit manager with a purpose beyond profits. They are seeking a Medication Therapy Management (MTM) Service Specialist Technician responsible for handling inbound and outbound calls to qualified members, gathering information about their medications, and ensuring compliance with MTM program processes.
Responsibilities
- Receive inbound and make outbound calls to eligible beneficiaries to schedule MTM clinician interventions in a manner that meets the specialized needs of the targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant
- Utilize Prime’s MTM process management system to record member specific information
- Assess beneficiary information to ensure appropriate interaction is scheduled with appropriate MTM clinician (i.e., Pharmacist)
- Perform outreach calls to pharmacies to research contact information
- Address and triage queries regarding MTM related topics by transferring calls to MTM staff or other department help lines
- Document MTM eligibility and program status in the applicable software systems (i.e., MSA Toolbox, RX Claim)
- Other responsibilities as assigned
Skills
- High School Diploma or GED required
- Must be eligible to work in the United States without the need for work visa or residency sponsorship
- Has suitable home office (i.e., chair, desk, internet, etc.) that meet Prime required standards (if work from home position)
- Strong interpersonal communication skills with focus on professional demeanor and empathy
- Strong verbal and written communication and problem-solving skills
- Strong organization skills with the ability to handle multiple tasks, prioritize and meet deadlines
- Proficient in Excel, Word, and system operations (e.g. workflow processes and case management)
- Government programs (Medicare) knowledge
- Contact Center experience
- Pharmacy and/or PBM experience
- 1 year of experience in healthcare industry
- Experience working with highly confidential medical information
- CPhT certification
- Fluency in another language (Spanish)
Company Overview
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