Pharmacy Outreach Coordinator

This is a fully remote position, open to applicants in New York.

📋 Description

• Offer administrative assistance for pharmacy initiatives and projects aimed at generating revenue, reducing pharmacy costs, minimizing member out-of-pocket expenses, and enhancing quality metrics.

• Engage in outreach efforts to providers, members, and pharmacies for clinical programs, including therapeutic interchange and initiatives focused on cost savings or quality improvements.

• Collaborate closely with clinical and analytical teams.

• Evaluate financial progress reports and prioritize tasks based on stakeholder expectations.

• Act as an outpatient medication access expert for local and remote members.

• Conduct routine quality assessments of system applications and functionalities.

• Propose methods for documenting, tracking, and measuring relevant information.

• Identify process inefficiencies, assess recommendation success rates, and recognize systemic failures with key personnel.

• Embrace new processes and procedural changes.

• Provide weekly updates to the department supervisor regarding assignments and provider outreach responses.

• Conduct initial assessments of claims files and data retrievals to pinpoint outreach cases.

• Prepare and assist with targeted outreach for patients and providers.

• Generate statistics on attempted outreach and incoming inquiries.

• Safeguard member privacy and adhere to corporate privacy policies, procedures, the Code of Conduct, and Lifetime Way values.

• Ensure consistent and reliable attendance.

• Perform additional functions as assigned by management.

• Level II: inform leadership about program successes, challenges, and barriers while recommending solutions.

• Level II: suggest improvements to processes and engage in resolving complex issues.

• Level II: mentor junior staff and assist with their coaching.

• Level II: manage weekly and monthly coordinator scheduling.

• Level II: support procedural modifications and enhance payer/provider relationships.

• Level II: develop detailed learning plans, speaking points, and educational resources.

• Level II: lead training sessions for new coordinators on program objectives, policies, procedures, and platform navigation.

• Level II: facilitate communication between coordinators, clinical pharmacists, and project management.

⛳️ Requirements

• High school diploma required.

• At least two years of experience in a health-related field.

• Pharmacy Technician certification (CPhT) is highly preferred.

• Experience in a doctor's office, hospital, infusion center, pharmacy, or customer service is strongly preferred.

• Basic knowledge of drug classifications and therapeutic interchange.

• Familiarity with prescription and medical benefits as they relate to utilization review and drug formularies is desired, but not mandatory.

• Current clinical knowledge essential for high-quality outreach interactions and intervention reconciliations.

• Excellent written, verbal, and telephone communication skills.

• High level of professionalism and a strong work ethic.

• Ability to maintain a positive demeanor with both internal and external customers.

• Capability to manage large volumes of information accurately through spreadsheets or databases.

• Strong customer service orientation.

• Effective interpersonal skills for engaging with internal and external stakeholders.

• Ability to work independently and utilize problem-solving and analytical skills.

• Level II: 2–3 years of experience in a health plan organization.

• Level II: fundamental understanding of medical terminology.

• Level II: clear comprehension of prescription and medical drug benefits and their design impacts.

• Level II: proficiency in Excel, company platforms, and databases.

• Level II: ability to navigate the healthcare system, including relationships with vendors and facilities.

• Level II: capacity to develop and enhance techniques for responding to providers, pharmacies, and members.

• Level II: ability to mentor and train less experienced staff.

• Willingness to travel across the Health Plan service region for meetings and/or training sessions.

• Capability to work from a home office for extended periods.

• Ability to operate a workstation using a computer, keyboard, mouse, and/or phone for three or more consecutive hours.

• Proficiency in hearing, understanding, and speaking clearly while using a phone.

🏝️ Benefits

• Group health and/or dental insurance.

• Retirement plan.

• Wellness program.

• Paid time off.

• Paid holidays.

• Potential for remote work on a case-by-case basis.

• Opportunity to work from a home office to ensure business continuity.

• Commitment to equal opportunity employment.