Location: New York,NY, USA
Overview Supports Pharmacy Services Specialists and Director of Pharmacy Services to perform Quality Improvement interventions, including maintenance of data integrity, member outreach and reporting to fulfill other regulatory requirements. Works under moderate supervision. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer-matched retirement saving funds Personal and financial wellness programs? Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care?? Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement? Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities?? Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals. Training provided on job-required roles. Flexible work schedule - Hybrid/Remote opportunities available. What Will You Do Assists with answering questions on pharmacy benefit inquiries. Conducts member outreach. Contacts members using standard script to assist with processing prescriptions, resolving copayment or ID card questions. Provides customer service and follow up on issues. Assists with retail pharmacy outreach. Contacts pharmacies to gather information and to resolve pharmacy benefit coverage and prescription eligibility and claim problems. Receives, downloads, reformats and reviews data in daily prescription claims files and reports. Conducts review of rejected/denied prescription claims data and screens for potential issues. Addresses non-clinical operational issues as a result of report review, and alerts pharmacist to clinical follow up when needed. Assists pharmacist with maintaining and tracking spreadsheets including obtaining, input and retrieval of prescription and related information. Participates in on-going quality of care geared interventions and abilities. Qualifications Licenses and Certifications: NYS Pharmacy Technician Certificate required Education: High School Diploma or the equivalent required Work Experience: At least one year of pharmacy experience required Managed Care Experience preferred Bi-lingual (Spanish) preferred Proficiency in Microsoft Office (Word, Excel, PowerPoint) required Compensation $20.98 - $26.23 Hourly About UsVNS Health is one of the nation's largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us-we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 neighbors who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.