Supervisor, Pharmacy Operations/Call Center at Molina Talent Acquisition

, , Azerbaijan -

Full Time

Start Date

Immediate

Expiry Date

27 Mar, 26

Salary

0.0

Posted On

27 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Pharmacy Operations, Call Center Management, Staff Supervision, Training and Development, Performance Metrics, CMS Compliance, Data Reporting, Customer Service, Communication Skills, Pharmacy Terminology, Problem Resolution, Policy Development, Quality Assurance, Team Leadership, Healthcare Knowledge, Call Center Experience

Industry

Hospitals and Health Care

Description

JOB DESCRIPTION Job Summary Leads and supervises a team of pharmacy call center representatives and operations staff responsible to ensure that members have access to medically necessary prescription drugs. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties • Hires, trains, develops, and supervises a team of pharmacy service representatives supporting processes involved with Medicare Stars and Pharmacy quality operations. • Ensures that average phone call handle time, average speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. • Ensures that adequate staffing coverage is present at all times of operation. • Assists pharmacy leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. • Responsible for key performance indicators (KPI) reporting to department leadership on a monthly basis. • Participates, researches, and validates materials for both internal and external program audits. • Acts as liaison to internal and external customers to ensure prompt resolution of identified issues. • Assists pharmacy leadership in the collection and tabulation of data for reporting purposes and maintains files of confidential information submitted for review. • Assures that activities and processes are compliant with CMS, National Committee of Quality Assurance (NCQA) guidelines, and Molina policies and procedures. • Participates in the daily workload of the department, performing Representative duties as needed. • Facilitates interviews with pharmacy service representative job applicants, and provides hiring recommendations to leadership. • Provides coaching for pharmacy representatives, and helps identify and provide for training needs in collaboration with pharmacy leadership. • Communicates effectively with practitioners and pharmacists. • Collaborates with and keeps pharmacy leadership apprised of operational issues, including staffing resources, program and system needs. • Assists with development of and maintenance of pharmacy policies and procedures • Participates in the development of programs designed to enhance preferential or required targeted drugs or supplies. Required Qualifications • At least 5 years of experience in health care, preferably within a health-related call center environment, or equivalent combination of relevant education and experience. • Knowledge of prescription drug products, dosage forms and usage. • Experience designing, implementing, monitoring, and evaluating metrics that measure call center agent productivity. • Working knowledge of medical/pharmacy terminology • Excellent verbal and written communication skills. • Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications • Supervisory/leadership experience. • Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. • Call center experience. • Managed care experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Responsibilities

The Supervisor leads a team of pharmacy call center representatives to ensure access to necessary prescription drugs and contributes to pharmacy strategy for optimizing healthcare outcomes. Responsibilities include hiring, training, monitoring performance metrics, and ensuring compliance with regulations.