Healthcare - Pharmacy Related Positions

WORK WITH ALL THE POSSIBILITIES!!

CORESTAFF Services is offering several Direct Hire positions within a Prescription Mail Order Company. The company is dedicated to providing innovative, clinically-based, cost-effective pharmacy solutions for clients and members. You will enjoy a supportive environment and plenty of advancement opportunity within a fast-growing business.

MEDICARE QUALITY ASSURANCE MANAGER- Salary up to $71k + 12% potential bonus

Specific responsibilities:

Act as key contact for clients and internal employees for items related to Medicare customer service issues.

Gather information from CMS, employees and clients and crafts agent alerts.

Ensure compliance with CMS requirements for Medicare customer service.

Establish a quality monitoring program for all Medicare lines of business at company and at our out sourced vendors; develop call monitoring criteria; conduct calibration sessions; oversee activities of quality monitoring analysts at vendors

Maintain accurate quantitative and qualitative records of multi-channel performance, tracks trends and performs analysis of root causes.

Review member grievances and other escalated Medicare issues and partner with Training to develop training materials; create agent alerts and quizzes to improve agent knowledge.

Conduct pre and post-quality analysis reporting on the effectiveness of training.

Maintain Contact Center quality assurance database.

Partners with Training to ensure that Training materials are kept current.

Qualifications:

Bachelor?s degree and 6+ years call center experience.

Minimum of 3 years QA management experience.

MEDICARE COMPLIANCE SPECIALIST - Salary up to 56k+ 12% potential bonus

Specific responsibilities

Maintain expert knowledge of Medicare Part D to ensure compliance with Part D regulations.

Serve as an in-house resource for questions involving Medicare Part D, with the ability to understand and communicate company?s Medicare Part D business operations, policies and procedures.

Work daily with Medicare Part D Advocates in The co. Contact Center to assist in resolving complex Medicare Part D issues. Respond to and oversee the completion of tasks and the resolution of items related to Government Programs listed in the Prime Call Tracker (PCT) within expected turnaround times.

Learn Contact Center and vendor processes and keep informed of any changes.

Communicate CMS content changes to Training Documentation Specialists and other Contact Center designees.

Qualifications:

Bachelor?s degree in business, healthcare management or related field or equivalent work experience.

Four to six years of work experience in the healthcare industry, with preference given to those with previous PBM experience.

CALL CENTER SPECIALIST ? Salary up to 35k

Specific responsibilities:

Represent company to MTMP eligible members via initial personal contact to identified members.

Conduct interviews with MTMP eligible members, guided by MTMP risk assessment and process management system, to confirm eligibility, determine risk assessment, assign intervention level.

Address and triage queries regarding MTMP received by inbound communications.

Qualifications:

CPhT (pharmacy technician certification) desirable.