3 years of pharmacy technician/pharmacy operations experience
Requirements:
Review assigned quality measure reports and identify members/providers/pharmacies with open gaps
Execute outreach to members/guardians, provider offices, and pharmacies via calls, letters, and faxes
Document outcomes and troubleshoot medication access barriers, escalating issues as needed
Maintain measure trackers, summarize outreach results, and communicate updates to the pharmacy/quality team
Job description
Summary:
Work Mode: Remote (Indiana preferred); Eastern Time business hours.
Duration: 4 months, possible extension based on business need/performance; conversion not anticipated for this temp assignment.
Shift: Monday-Friday, 8:30am-5:00pm ET (flex as needed for outreach/operational needs). Occasional OT may be required during peak measure cycles.
Responsibilities:
Review assigned quality measure reports and identify members/providers/pharmacies with open gaps.
Execute outreach to members/guardians, provider offices, and pharmacies via calls, letters, and faxes.
Document outcomes and troubleshoot medication access barriers, escalating issues as needed.
Maintain measure trackers, summarize outreach results, and communicate updates to the pharmacy/quality team.
Ensure timely completion of assigned outreach within SLA/cadence and accurate documentation and tracking.
Contribute to the measurable closure of gaps and reduction of outstanding adherence/quality opportunities.
Maintain strong attention to PHI compliance and member experience.
Requirements:
Required Education: High School Diploma/GED.
Required Licensure: Pharmacy Technician License.
3 years of pharmacy technician/pharmacy operations experience (managed care and/or quality/outreach experience strongly preferred).
Disqualifiers: No active/eligible Pharmacy Technician license (Indiana), inability to work independently, poor communication/customer service skills, discomfort with outbound outreach, inability to use Excel for report review/tracking, non-compliance with PHI/required documentation.
Preferred Skills:
Highly organized self-starter with strong attention to detail.
Able to prioritize competing deadlines across multiple measures.
Confident in communicating with provider offices/pharmacies and members/guardians.
Experience with HEDIS/Stars measures and medication adherence interventions.
Proactive problem-solver who can identify barriers and escalate appropriately.
Pharmacy technician operations expertise, including medication access support such as prior auth/formulary navigation.
Advanced Excel/report skills for filtering/sorting, data cleanup, and ability to build/maintain trackers and summarize results.
Quality measure/HEDIS outreach workflow experience, including interpreting measure gap lists, executing outreach, and documenting outcomes.
