Rx Clinical Programs ORM Pharmacy Tech - Humana
Santa Fe, NM
About the Job
Become a part of our caring community and help us put health first
Be a part of our Pharmacy Clinical Programs Overutilization Review and Monitoring team. Provide guidance to members who have potential medication over utilization or medication interaction concerns. Your role will be to work within the process parameters to help make connections with health care providers that will guide our members' treatment and ensure medication safety.
Location: Remote Nationwide
Shift: 9AM-5:30 PM Eastern Monda-Friday
The Rx Clinical Programs ORM Pharmacy Technician Representative 2 assists in reviewing members pharmacy history for overutilization. Job is to manage the case when it is determined that the member would benefit from a program that would help them manage how they obtain their medications.
+ Share the results of review and provide analytical support for case reviews by case management.
+ Take action on any recommendation from case management.
+ Generate and analyze reports related to prescription fills, maintain caseload, prepare cases for case management recommendation, and take case action as directed.
+ Run reports to support the internal requests for data and analysis as related to medication overutilization as required.
+ Interface with internal and external resources to ensure successful change in members' medication overutilization or drug seeking behavior.
+ Outbound calls to prescribers and pharmacies to validate demographics.
+ Inbound calls from prescribers, pharmacies and members to educate and assist with overutilization programs.
+ Coordinate and address any letter communication as directed by case management.
+ Prepare presentations and communication materials on behalf of the Clinical Programs Overutilization Review and Monitoring.
+ Coordinate and plan meetings as required.
Use your skills to make an impact
Required Qualifications
+ Pharmacy Technician license (if required to practice in the state where you live)
+ National Pharmacy Technician - PTCB or ExCPT
+ 1+ years of experience working as a Pharmacy Technician
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel and PowerPoint, workflow management systems
+ Strong verbal and written communication skills, including the ability to tailor communication to audience
+ Ability to handle multiple tasks, meet deadlines, and follow-up timely
+ Previous experience working with data analysis & problem-solving skills
Preferred Qualifications
+ Previous experience with pharmacy claims
+ Previous experience performing pharmacy data entry
+ Bachelor's degree in business or a related field or equivalent experience/education
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$37,200 - $51,200 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Be a part of our Pharmacy Clinical Programs Overutilization Review and Monitoring team. Provide guidance to members who have potential medication over utilization or medication interaction concerns. Your role will be to work within the process parameters to help make connections with health care providers that will guide our members' treatment and ensure medication safety.
Location: Remote Nationwide
Shift: 9AM-5:30 PM Eastern Monda-Friday
The Rx Clinical Programs ORM Pharmacy Technician Representative 2 assists in reviewing members pharmacy history for overutilization. Job is to manage the case when it is determined that the member would benefit from a program that would help them manage how they obtain their medications.
+ Share the results of review and provide analytical support for case reviews by case management.
+ Take action on any recommendation from case management.
+ Generate and analyze reports related to prescription fills, maintain caseload, prepare cases for case management recommendation, and take case action as directed.
+ Run reports to support the internal requests for data and analysis as related to medication overutilization as required.
+ Interface with internal and external resources to ensure successful change in members' medication overutilization or drug seeking behavior.
+ Outbound calls to prescribers and pharmacies to validate demographics.
+ Inbound calls from prescribers, pharmacies and members to educate and assist with overutilization programs.
+ Coordinate and address any letter communication as directed by case management.
+ Prepare presentations and communication materials on behalf of the Clinical Programs Overutilization Review and Monitoring.
+ Coordinate and plan meetings as required.
Use your skills to make an impact
Required Qualifications
+ Pharmacy Technician license (if required to practice in the state where you live)
+ National Pharmacy Technician - PTCB or ExCPT
+ 1+ years of experience working as a Pharmacy Technician
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel and PowerPoint, workflow management systems
+ Strong verbal and written communication skills, including the ability to tailor communication to audience
+ Ability to handle multiple tasks, meet deadlines, and follow-up timely
+ Previous experience working with data analysis & problem-solving skills
Preferred Qualifications
+ Previous experience with pharmacy claims
+ Previous experience performing pharmacy data entry
+ Bachelor's degree in business or a related field or equivalent experience/education
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$37,200 - $51,200 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Source : Humana