Team Lead, Pharmacy MTM Services (Rx Partners)

UPMC Rx Partners is looking for a Member to Member, Pharmacy Team Lead to join their dedicated team!

You will support the provision of pharmaceutical care through member, pharmacy, and provider interactions to discuss and resolve medication related issues. These services will be provided in compliance with state and federal regulations, NCQA standards, the mission, policies and procedures of UPMC Health Plan and the Pharmacy Department. Assist with the team attainment of designated call service standards. Ensure excellent customer satisfaction for both internal and external customers. Effectively monitor calls queues and volumes. Assume supervisory responsibility as necessary. Assist with the development and training of new team members.

This role will daylight shifts, Monday through Friday. Occasional weekend (twice a year) for holiday prep.

UPMC offers a generous benefits package, an expansive total rewards package, opportunity to grow your career and much more. Apply today!

Responsibilities:

• Participate in departmental quality improvement activities, including clinical opportunities as well as operational efficiencies in order to continually improve and evaluate pharmaceutical care as reflected by operational and patient care indicators.
• Adhere to organizational procedures, including ensuring secure privacy and confidentiality as required by HIPAA, employing effective communication methods to maintain call control, documenting appropriate comments, and acting in alignment with all State Regulations and Federal Laws.
• Support and develop cross-functional team members. Maintain a positive work environment through employee recognition and interaction. Assist in the development/refinement of policies and procedures. Support other departments as requested during periods of backlogs.
• Maintain reports to assist in attainment of standards, identify root cause of potential or existing problems. Participate in interviewing, hiring and training of team members when requested. Participate in team meetings and provide information to team members in a timely manner.
• Tracks trends and recommends solutions to existing problems. Continually examine team performance, provide feedback, make recommendations and implement action plans to meet designated standards. Monitor and refine workflow to facilitate communication and teamwork between departments.
• Ensures first call resolution to effectively resolve member needs and concerns. Serves as a subject matter expert to identify and provide timely feedback for quality related call service issues and assists in resolving these issues. Reports and responds to escalated issues and concerns in a timely manner.
• Engages in the execution of medication therapy management protocols through interventions with members, pharmacies, and providers. Allocate resources to ensure attainment of all call performance standards. Monitor and manage queue volumes. Assist with the attainment of phone call quality to meet or exceed the minimum standard established and ensure appropriate documentation of calls through consistent one-on-one call coaching.

Qualifications:

• Completion of High School Diploma or equivalent.
• College degree preferred.
• At least 3 years of combined customer service or call center experience with at least 1 year in a healthcare setting.
• Excellent organizational, interpersonal and communication skills.
• Strong analytical ability. Advanced Microsoft Office/PC skills.
• Knowledge of Pharmacy MTM services required.
• Ability to make independent decisions required.
• Ability to resolve member concerns.
• Excellent problem-solving skills.
• Strong time management skills and ability to work in a fast-paced environment.
• Certified pharmacy technician preferred.
  Licensure, Certifications, and Clearances:
  
  UPMC is an Equal Opportunity Employer/Disability/Veteran

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