Summary
The Pharmacy Care Coordinator helps analyze client data to identify members that would benefit from Evernorth intervention, contact members and execute select intervention activity. Interventions include, but are not limited to, recommending low-cost pharmacy options, assessing member’s drug therapy readiness, educating and referring members on potential point solutions offerings and coordinating conversations with internal clinician partners.
The primary focus of this position is to direct employees to the maximum use of their benefits, establish relationships, coordinate care, advocate for the employee, provide wellness and health promotion services and patient education.
Description
The Pharmacy Care Coordinator supports quality, safety, and trend initiatives within the Evernorth Workplace Care department. Their primary focus is to execute a specific basket of interventions on a given client population. The role will require both member facing and client facing activity. The Pharmacy Care Coordinator will also serve as a liaison to a variety of internal and external teams, provides timely responses to inquiries, and maintains a record of activities and results, as appropriate.
The Pharmacy Care Coordinator works well independently, as well as collaboratively including with account teams to ensure clients and their members receive superior service.
Responsibilities Include
- Conduct comprehensive appraisals of patient’s health status by taking health histories and drug histories
- Work with care team to execute therapeutic plans using the most clinical and economically effective medication treatment per protocol or clinical guidelines.
- Evaluate and document patients’ and caregivers’ ability to understand medication instructions and provide oral education on their medications.
- Provide patient education and medication information.
- Use multiple data analytics programs that provide the patient/member on:
- Medication compliance
- Chronic Condition support
- Physician referrals
- Referral to Case Management for authorization assistance
- Retail/mail order and benefit questions
- Assist on any customized projects and outreach for the Client served.
- Example: promotion of generic and formulary prescribing and advising on formulary changes, etc.
- Analytics programs that will improve clinical and financial outcomes and support trend management include:
- Customer Service Platform /Portal (f/k/a Service Delivery); read-only holistic view into transactional history
- Health Connect 360 Care Insight Hub – no codes – just engagement – identification of clinical opportunities
- HealthEview – view into coaching and claims history
- TRC tool – better documentation potential – has codes that might be able to generate reporting
- Intellisphere – more identification/holistic data
- Document activity in available tools, working with the analytics team to track outcomes both clinically and financially.
- Empower customers to become an active participant in their own health outcomes.
- Assist Customer in overcoming barriers to overall better health.
- Act as onsite Benefits Champion: Participate in monthly benefits training program to better triage patient/customer to the right resources and services, such as connecting them to other services including tobacco cessation, nutrition education, etc.
- Proactively create a culture of personal health and responsibility through the development, distribution, delivery and posting of educational materials using available distribution/posting resources.
- Effectively participate in staff meetings and with matrix partners to share best practices, improve processes.
- Collaborate with our matrix partners to support the overall health and wellness strategy of the aligned client.
Qualifications
- Current Certified Pharmacy Tech (CPht) License is strongly preferred OR at least a minimum of 3 or more years clinical experience with pharmaceuticals
- At least 2 or more years of general pharmacy experience; 2 or more years in managed care, the PBM industry, or pharmaceutical sales preferred
- Ability to establish and maintain patient relationships.
- Excellent verbal, presentation, and written communication skills required.
- Proven leadership skills, team-orientation, a proactive management style and strong commitment to client service a must.
- Ability to work on multiple tasks, prioritize, resolve complex issues, and have strong project management skills.
- Ability to learn multiple internal reporting and analytic tools and use advanced problem-solving skills.
- Work independently, as well as collaboratively.
- Comfortable in the delivery of service in various work environments
- Knowledge of PBM industry preferred.
- Proficiency in using Microsoft Office applications and ability to talk and type at the same time, with multiple tabs/programs open
This role is remote but Pharmacy Care Coordinator must reside in California.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 17 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. 
