Pharm Outreach Specialist - Wellbe Senior Medical

WELLBE INTRODUCTION

The WellBe care model is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients. This population is typically underserved and very challenged with access to care. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care – from chronic care and urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care. WellBe's physician/advanced practicing clinician led geriatric care teams’ partner with the patient’s primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.

GENERAL SUMMARY

The pharmacy outreach specialist plays an integral role by assisting patients in adhering to their medication regiment as well as by coordinating with pharmacies in distributing medication to patients. This position on the central quality initiatives team will act as a liaison between patient, provider, and pharmacy to promote medication adherence and improve pharmacy quality measures, specifically the Part D STARS measures proportion of days covered (PDC).

The pharmacy outreach specialist will conduct patient outreach to identify and address medication adherence barriers and serve as a medication adherence subject matter experts for the organization. This important role will contribute to increasing overall quality ratings by ensuring patients refill and take their medication on time and as directed.

The pharmacy outreach specialist is responsible for pursuing new medications and/or refills for our patients. You will pursue medications for our patients by sending faxes, calling doctors, and calling our patients. These positions are call oriented, repetitive, and fast-paced. To be successful in this job you must be very comfortable working on several different computer programs and can interpret data quickly and accurately. You will process a substantial amount of patient information every day. You will have the satisfaction of knowing that YOU are helping our patients receive their medications, and that will help them be more adherent and stay healthier longer.

We are looking for an individual with strong telecommunications and quality experience to engage patients that have been identified as having a medication adherence gap or issue with filling timely medication(s) and help coordinate their refills.

The ideal candidate will have excellent communication skills, attention to detail and comfortable working in a dynamic environment. You likely thrive under pressure and see ambiguity and uncertainty as your opportunity to solve problems, innovate and deliver.

You will be expected to work both independently and as part of a team within a multi-disciplinary environment. This is truly an exciting time to contribute to high quality patient care and improve clinical outcomes for patients.

POSITION RESONSIBILTIES

• The pharmacy outreach specialist plays an integral role by assisting patients adhere to their medication regiment and by assisting clinicians and pharmacies in distributing medication to patients
• The pharmacy outreach specialists are responsible for pursuing new medications and/or refills for our patients by completing telephonic outreach to patients to identify and address medication adherence barriers
• You will pursue medications for our patients by faxes, calling doctors, and calling our patients
• These positions are call oriented, repetitive, and fast-paced
• You will have the satisfaction of knowing that YOU are helping them receive their medications, and that will help them be more adherent and stay healthier longer
• Reach and maintain productivity and quality metrics
• Assist in developing logic to target highest priority patients for outreach
• Contact prescribers offices via telephone in pursuit of medication
• Contact patients via telephone and text in pursuit of medication
• Provide one call resolution on all calls
• Keep a high level of professionalism when speaking patients, providers, and other employees
• Keep lines of communication open with the team members to address potential issues that may arise
• Conducts medication compliance calls to patients
• Gathers and records appropriate member information in accordance with policies and procedures via telephone
• Educates patients on importance with medication adherence, formulary, medication resources or assistance programs
• Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services
• Records call details and utilize call scripts as needed based on client requirements
• Completes & coordinates medication refill with retail pharmacies, primary doctor, or other clinicians, as required. Contacts physician offices to obtain demographic information or related data as needed
• Confirms patients' demographic information as necessary for mail order prescriptions
• Transfers prescriptions as requested by patients or other pharmacies
• Triages calls/voicemails, working to resolve any outstanding prescription issues, as appropriate
• Directs member inquiries to appropriate clinical staff
• Maintains record keeping and generates reports related to outreach, and other ad-hoc reports
• Adheres to HIPAA requirements while contacting patients, providers, and other pharmacy staff
• Applies excellent communication, customer service, and problem-solving skills to all interactions

QUALIFICATIONS

Educational/Experience Requirements:

• High school diploma or equivalent
• Minimum of 3 years of experience in customer service or outreach demonstrating ability to influence customers/ members; or any combination of education and experience, which would provide an equivalent background
• Pharmacy Tech Certification, or Training required

Required Skills and Abilities:

• Easily navigates through multiple computer systems
• Comfortable on the phone to engage with patients, pharmacies, doctor offices, insurance companies, etc.
• Call Center Experience
• Strong proficiency in MS Office (e.g. Excel) and Google documents/spreadsheets
• Ability to synthesize and analyze large amounts of data to make sound business decisions
• Requires strong oral, written, and interpersonal communication skills, problem-solving and facilitation skills
• Excellent detail orientation and organizational skills
• Strong orientation towards patient-centric care creating an unmatched patient experience

Travel requirements: Occasional travel might be required for this position

Work Conditions:  This position will work in a variety of settings, e.g. office. The noise level in the work environment is usually moderate.   Requires prolonged sitting.  Requires bending, stooping, twisting, kneeling, crouching, crawling and/or stretching from seated or standing positions. Requires eye-hand coordination and manual dexterity sufficient to operate medical equipment, frequently operates a keyboard, telephone, copier, calculator, and other office equipment.  Manual dexterity and coordination necessary to operated office equipment, telephone, keyboard, copier and calculator.  Requires close vision, peripheral vision, and ability to adjust visual focus, hearing and smelling.  Must be able to communicate information via telephone or computer.  Requires moderate to intense concentration due to complexity.  Must be able to lift and/or move up to 25 lbs.

The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.

WellBe Senior Medical is an equal opportunity employer. We embrace diversity, inclusion, and equity and encourage all interested readers to apply at careers-wellbeseniormedical.icims.com