JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.
Essential Job Duties
- Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met.
- Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence.
- Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations.
- Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated.
- Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required.
- Utilizes appropriate resources to ensure member contact information is current and up-to-date.
- Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members.
- Interacts with appropriate primary care providers to ensure member registry is current and accurate.
- Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation.
- Proactively identifies ways to improve member relations.
- Supports goal to achieve and maintain industry-leading Medicare STAR ratings.
Required Qualifications
- At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience.
- Excellent customer service skills.
- Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc.
- Ability to multi-task applications while speaking with members.
- Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors.
- Ability to meet established deadlines.
- Ability to function independently and manage multiple projects.
- Excellent verbal and written communication skills, including excellent phone etiquette.
- Microsoft Office suite, and applicable software program(s) proficiency.
Preferred Qualifications
- Health care industry experience.
- Pharmacy related 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
Pay Range: $21.16 - $28.82 / HOURLY
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type Full Time Posting Date 10/03/2025
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