Certified Population Health Pharmacy Technician - Full-Time - Day

Schedule

Full-Time: 40 Hours/Weekly

M-F 8-430

General Summary

Supports the pharmaceutical management efforts across the continuum of care from utilization management to care management to adherence for value-based care populations served through WellSpan Population Health Services (WPHS). This role utilizes Epic and other resources to gather needed information for other team members while assuring excellence in the patient and provider experience. While some aspects of the role are highly regulated there are many opportunities for innovation for which this team member will be uniquely positioned to influence.

Remote Work Capableessential Functions:

• Receives and prepares information, gathers new information, and completes in collaboration with utilization management (UM) team members through Epic for authorization requests.
• Manages and assists in communications to physician offices/pharmacies/members/other departments to obtain additional information and to keep physicians/pharmacies/members aware of current authorization status. This work will be conducted with a focus on an exceptional customer experience.
• Collaborates with care management team members and others in the WellSpan Health system including patient outreach to achieve adherence goals established within value-based and pay-for-performance programs. This effort includes monitoring reports, performing patient/provider outreach, and assuring accuracy of information in data sources.
• Retrieves information and builds reports as needed from various sources to support the efforts of utilization management and success in value-based care.
• Collaborates with WPHS customer service team members and the pharmacy benefit manager to assist members in understanding and navigating the processes for utilizing their health plan or other contracted benefits.
• Assists in utilization management and care management improvement efforts (development, establishment, implementation of goals, objectives, policies, and procedures) leveraging the LDMS process. This includes receiving complaints/issues elevated from other sources outside of the department.
• Performs member outreach activities related to adherence with a focus on achieving the best health outcome for members while contributing to quality performance success.

Common Expectations:

• Maintains established policies and procedures, objectives, quality assessment, and safety standards.
• Maintains personal professional growth and development.
• Maintains a balance of productivity, quality, and timeliness of job accountabilities. Participates in department self-audit or other compliance procedures.

Qualificationsminimum Education:

• High School Diploma or GED Required
• Bachelors Degree Preferred

Work Experience:

• 2 years Retail or other experience as a pharmacy technician. Required
• 1 year Experience in third-party administration pharmacy management, utilization or care management, health plan benefits, or a role in a pharmacy benefit manager or health plan. Preferred

Licenses:

• Certified Pharmacy Technician Upon Hire Required

Courses And Training:

• Health Plan related certifications (e.g., billing and reimbursement, medication therapy management, medication history) Upon Hire Preferred

Knowledge, Skills, And Abilities:

• Collaborative, displaying skill in seeking partners to accomplish goals.
• Excellent communicator in individual and group settings.
• Displays a willingness to learn from others with a mindset of personal self-awareness.
• Growing skills at critical thinking in a clinical setting.
• Independent worker able to take direction and complete tasks with minimal supervision.
• Self-directed learner and problem-solver.

Benefits Offered:

• Comprehensive health benefits
• Flexible spending and health savings accounts
• Retirement savings plan
• Paid time off (PTO)
• Short-term disability
• Education assistance
• Financial education and support, including DailyPay
• Wellness and Wellbeing programs
• Caregiver support via Wellthy
• Childcare referral service via Wellthy

WellSpan Health’s vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region’s largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.