Job Details

Remote Caregivers (Primarily Remote)

Under direct supervision of operations manager, performs benefit investigation tasks such as running test claims, submitting prior authorizations, documenting on the patient chart, and completing patient outreach and follow up calls.

Major Responsibilities:

• Completes benefit investigations when requested by Advanced Therapeutics PharmD and APP team and appropriately documents result on patient electronic medical record.
• Submit prior authorizations to insurance via different methods including online and telephone. Appeal decisions as necessary and conduct follow up phone call inquiries to insurance.
• Knowledgeable in manufacturer patient savings opportunities and communicates information clearly and effectively to providers and patients.
• Performs follow up phone calls to patients as needed regarding insurance decisions, rejections, and prescription filling information.
• Maintains a perpetual inventory of appropriate medications from internal pharmacies and communicates to clinic team daily.
• Coordinates prescription delivery with patient and Home Delivery pharmacy and queues prescription up for home delivery team.
• Maintains a clean work area and assists in quality indicator monitoring.
• Participates in identifying problems or areas for improvement and assists manager with problem solving projects and improving operations; participates in Continuous Quality Improvement activities and/or teams.

Position Qualifications:

License/Certification/Education: Required:

• High school diploma or equivalent.
• Current license with the Massachusetts Board of Pharmacy.
• Certified by one of the national governing bodies such as Pharmacy Technician Certification Board PTCB, or the National Healthcareer Association ExCPT. If the individual is not nationally certified they must become certified within 6 months of hire.

Experience/Skills:

Required:

• Minimum of one year of related experience as a Pharmacy Technician.
• Position requires proficiency in math and, knowledge and ability to use a computer.
• Must be able to follow oral and written instructions with accuracy, efficiency, and dependability.
• Ability to work in a hybrid or remote environment.
• Positive work ethic, motivated and professional demeanor to promote teamwork in the department.

*MUST reside in MA*

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We're striving to make respect a part of everything we do at UMass Memorial Health for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ...@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.