As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. Join us and start doing your life's best work.(sm)
The Pharmacy Support Specialist will make outbound calls to members and physicians to improve medication adherence and other pharmacy related quality metrics. Responsible for gathering prescription refill orders and providing excellent customer service as well as troubleshooting any pharmacy related issues.
Please note: This position is office based off of Northwest Parkway in San Antonio, TX. Our office hours are M-F 8 am - 7 pm. Start times will rotate between 8 am, 9 am and 10 am. One 4 hour Saturday shift per month is required.
- Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers
- May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary
- Follows system scripting and validates member demographic information
- Documents the provider or member's record with accurate information obtained on the call
- Performs desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate
- Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues
- Participates in and contributes to the overall pharmacy quality improvement initiatives
- Collects and maintains eligibility information in an appropriate and confidential manner
- Exhibits excellent phone and communication skills while providing complete and accurate information to members
- Adheres to assigned schedule and quality metrics
- Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders
- Follows all policy and procedures for Medication Adherence Initiative
- Performs all other related duties as assigned