Pharmacy Call Center Specialist - Outer Cape Health Services

Our Culture: Why work with us?

Joining Outer Cape Health Services isn't just about taking on a new role; it's about embracing a mission that goes beyond the day-to-day. Here, you become part of a dedicated team committed to safeguarding and nurturing invaluable community health resources. Our ethos is built on creating a vibrant and inclusive workplace where every team member is valued and recognized for their unique contributions.

Who We Are :

Our mission is to provide a full range of primary health care and supportive social services that promote the health and well-being of all who live in or visit the ten outermost towns of Cape Cod.

OCHS now cares for more than 18,000 patients annually, and no one is denied access to services due to an inability to pay. Founded in 1987 through the merger of Health Associates of Provincetown (established in 1972) and the AIM Medical Center in Wellfleet (established in 1966), Outer Cape Health has a long history of successful growth and expansion in pursuit of this mission. As a Patient-Centered Medical Home, OCHS holds itself to the highest standards. Ensuring patients have access to care when they need it and request it, and validating that staff are working at the top of their licensures, are foundations of this model.

Our Core Competencies:

At Outer Cape Health Services, our core competencies are the foundation upon which our organization is built, guiding us in our mission to deliver exceptional health services to our communities. Our focus on fostering teamwork ensures that we operate as a cohesive unit, valuing each member's contribution and working synergistically towards common goals. Integrity and honesty stand at the heart of everything we do, creating a culture of trust and respect among our team and the communities we serve. Embracing technology, we continually seek innovative solutions to enhance our services and operations. Finally, being patient-centered, we prioritize the needs and well-being of those we serve, striving to exceed expectations and make a meaningful difference in their lives.

A day in the life of this role:

At Outer Cape Health Services, it is our very basic belief that it is people who have made Outer Cape Health Services' growth and success possible and that we have been fortunate in employing people who take pride in the services we provide. Our goal at OCHS is to employ those who (1) always meet or exceed OCHS' standards; and (2) care enough to ensure that whatever they do, they do well.

Summary of duties:

• Works on payment appeals and denials.
• Keeps Pharmacy Director informed about audit and payment issues/projects.
• Mentors and trains other pharmacy staff on department workflows and QS1 functionality.
• Assists with Patient Assistance Programs, where applicable.
• Prepares prior authorization, via CoverMyMeds and communicate where needed with provider and patient.
• Performs other functions of the Pharmacy Call Center as required.
• Monitors fax inbox to ensure medication related faxes are handled in a timely manner.
• Prepares in accordance with pharmacy law and standards of pharmacy practice, outpatient RX's to be dispensed after pharmacist approval.
• Provides exceptional customer service and accommodate customer needs in a timely, efficient, and caring manner.
• Prepares telephone encounter as needed to providers, pharmacy staff or nurse.
• Answers telephone inquiries about medications, referring callers to pharmacist when necessary.
• Performs duties assigned by a licensed pharmacist. Areas of work are checked routinely for maintenance of quality control. Work is conducted in accordance with generally accepted standards of practice following departmental procedures and policies as outlined in the department operations manual.
• Perform refill reminders by site when necessary.
• Manage prescriptions at other pharmacies when needed
• Check the Prescription Monitoring Program (PMP)
• Assist in formulary switches of medication when necessary
• Assist with prescriptions for the Optometry Department
• Responsible for tracking prescription deliveries
• Responsible for referrals to Specialty Pharmacies

What we need from you:

• Registered and/or Certified Pharmacy Technician license
• 3 or more years of pharmacy or medical experience
• Knowledge of medical and pharmacy terminology
• An understanding of pharmacy computer system operations (hardware, software, and operating systems), contracting, billing, and pricing
• Excellent computer skills
• Excellent customer service skills
• Able to work in a fast-paced environment
• Must be prudent, ethical, and credible and use good judgment.
• Effective communication skills and the ability to work collegially with a wide variety of professionals in a fast-paced health care setting
• Reasoning ability (logic) to apply common sense understanding to carry out instructions furnished in written, oral or diagram form.
• Ability to deal with problems involving several concrete variables in standardized situations.
• Knowledge of and experience with QS 1 and eCW software
• Inventory knowledge

AAP/EEO Statement Outer Cape Health Services is committed to a firm policy in favor of equal employment opportunity and will abide by all applicable state and federal regulations by not discriminating against any applicant or employee on the basis of race, religion, color, creed, sex, age, national origin, citizenship status, marital status, sexual orientation, gender identity and expression, disability or veteran status. Our commitment to equal employment opportunities shall include employment, upgrading, promotion, demotion, transfer, leaves or other absences from work, layoff, compensation and benefits, selection for training or other education, professional opportunities and conflict resolution.

It is also the policy of OCHS to take affirmative action to employ and to advance in employment, all persons regardless of their status as woman, minority or individuals with disabilities or protected veterans, and to base all employment decisions only on valid job requirements.

Please inform us of any necessary accommodations required during the application process and/or at any time during employment.