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   Current UPMC employees must apply in HR Direct

Pharmacy MTM Service Representative

Description


Our Pharmacy Service Representatives support the provision of pharmaceutical care through member, pharmacy, and provider interactions to discuss and resolve medication related issues. These services will be provided in compliance with state and federal regulations, NCQA standards, the mission, policies and procedures of UPMC Health Plan and the Pharmacy Department. Individuals should demonstrate professionalism and commitment to meet UPMCHP goals and objectives.

Responsibilities:

  • Complete calls efficiently and with high quality to meet call center key performance metrics.
  • Remains current on departmental policies, procedures, formularies, and regulatory standards.
  • Receive inbound calls from and deploy outbound calls to members, pharmacies, and physicians determining the appropriate action and understanding the appropriate cases to escalate to a pharmacist.
  • Supports the pharmacist with completion of comprehensive medication reviews through pre-work up and case preparation.
  • Maintain all patient information and records. Maintain the pharmacy computer system as required.
  • Adhere to organizational procedures, including ensuring secure privacy and confidentiality as required by HIPAA, employing effective communication methods to maintain call control, documenting appropriate comments, and acting in alignment with all State Regulations and Federal Laws.
  • Ensures first call resolution to effectively resolve member needs and concerns.
  • Engages in the execution of medication therapy management protocols through interventions with members, pharmacies, and providers.
  • Participate in departmental quality improvement activities, including clinical opportunities as well as operational efficiencies in order to continually improve and evaluate pharmaceutical care as reflected by operational and patient care indicators.
  • Assist in the training of pharmacy personnel and students.
  • Complete appropriate documentation regarding interventions.

 

Qualifications

  • Completion of High School Diploma or equivalent
  • Minimum 1 year customer service and/or call center experience
  • Previous health insurance or pharmacy experience is preferred
  • Certified pharmacy technician preferred
  • Excellent organizational, interpersonal, and communication skills

    Licensure, Certifications, and Clearances:

    UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life &emdash; because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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