Job Description
HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 200+ skilled professionals dedicated to ensuring members have access to the highest quality of care while efficiently utilizing healthcare resources.
HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care. Interested in joining our successful Garden City Team? We are currently seeking a
Pharmacy Technician! Position Summary:
The Pharmacy Technician in HealthCare Partners Managed Services Organization plays a vital role in supporting Clinical Pharmacists and the pharmacy team, facilitating effective patient care. This position involves collaborating with the utilization management team to process pharmacy-related utilization requests and conducting medication adherence outreach to improve patient compliance. Essential responsibilities include accurately documenting utilization management processes, participating in strategy development, and maintaining knowledge of pharmacy regulations and quality measures.
Essential Position Functions/Responsibilities:
- Collaborate with the utilization management team to review and process pharmacy-related utilization requests, including prior authorizations and appeals, ensuring adherence to established protocols and regulatory guidelines.
- Assist in conducting thorough reviews of medication requests, medical records, and clinical criteria to determine the medical necessity and appropriateness of requested pharmacy services.
- Communicate with healthcare providers and prescribers to gather additional information or clarify details related to quality measures, chart chasing, or utilization management.
- Maintain accurate documentation of outreaches and communications with members, providers, and pharmacies to ensure proper records are maintained for auditing and reporting purposes.
- Participate in the development and implementation of department strategies, contributing insights and suggestions based on your pharmacy expertise.
- Conduct medication adherence phone outreach to patients, providing information, education, and support to improve patient compliance with prescribed medications.
- Track and assign medication reconciliation post-discharge calls from the Care Management Department.
- Appropriately identify barriers related to a member’s case, including cost concerns, transportation, and clinical issues that arise during outreaches for the appropriate escalation to a Pharmacist or another team internally.
- Maintain a strong understanding of pharmacy regulations, clinical guidelines, and quality measures related to medication adherence.
- Assist in reporting data related to Pharmacy Department activities such as medication adherence and utilization management, contributing to performance improvement initiatives.
- Provide timely and accurate reports on utilization management trends, medication adherence rates, and related metrics to support decision-making.
- Manage inbox for Pharmacy Department correspondence.
- Maintain patient confidentiality and adhere to all privacy regulations, including HIPAA.
- Participate in ongoing training and professional development to stay updated on industry trends, pharmacy best practices, and healthcare regulations.
Qualification Requirements:
Skills, Knowledge, Abilities
- Knowledge of medical conditions and medications.
- Ability to engage members telephonically and effectively communicate relevant and appropriate education.
- Empathetic and patient-centered approach in communication, especially during medication adherence outreach.
- Ability to think critically to determine appropriate intervention based on member needs.
- Ability to document appropriately member/family/provider/pharmacy discussions and interventions.
- Detail-oriented and accurate in documentation, data entry, and adherence to processes.
- Ability to work collaboratively in a team-based environment, supporting the goals of the utilization management and pharmacy teams.
- Excellent communication skills, both written and verbal, with the ability to interact effectively with patients, healthcare professionals, and colleagues.
- Flexibility to adapt to changing procedures and operational needs within the managed services organization.
- Knowledge of Microsoft Office Programs (Word, Excel, PowerPoint).
- Ability to work remotely on weekends on a rotating schedule to screen and process urgent pharmacy authorization requests.
Training/Education:
- High School Diploma/GED, required
- Associates degree or equivalent experience, required
- Pharmacy Technician Certification, preferred
Experience:
- Previous experience as a Pharmacy Technician, especially in a utilization management or medication adherence programs preferred
- 3+ years’ experience in managed care environment preferred
- 3+ years in medication management preferred
- Experience with pharmacy quality measures preferred
- Experience with utilization management and quality improvement processes
Salary Information: Annual Base Compensation: $24-27 per hour (equivalent to $50,000-$55,000 per year)
Bonus Incentive: Up to 5%, based on organizational performance
HealthCare Partners, MSO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HealthCare Partners, MSO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. The above position information is intended to describe the general nature and level of work being performed by the job incumbent(s) and is not to be considered an all-encompassing description of all responsibilities, duties, and skills required.
Job Tags
Hourly pay, Full time, Local area, Immediate start, Remote job, Weekend work,