Job DescriptionThe Pharmacy Quality Specialist will provide assistance to Pharmacists and/or Advanced Practice Clinicians to support Medication Therapy Management (MTM) and quality programs. The Pharmacy Quality Specialist will complete outreach calls to eligible health plan members and/or caregivers to introduce and explain the MTM benefit, verify and obtain demographic and medication-related information, including documentation of medication lists, schedule appointments for the MTM Pharmacist to complete the comprehensive medication review or target intervention. This position will also support Medicare Star and other quality initiatives.What You'll Do
Verify member demographic information, provider and pharmacy contact information and enter into the MTM platform as needed
Contact members to introduce and explain the benefits of the MTM program and follow up as needed and to schedule appointments for the MTM Pharmacist to complete the Comprehensive Medication Review or the Targeted Intervention
Receive and respond to calls from provider offices, members and pharmacies; make determinations of appropriate action required from calls and escalate calls as needed
Coordinate outbound faxing and subsequent follow-up calls with health care providers
Assess and interprets member needs and requirements, triaging to a clinical pharmacist or other areas when appropriate
Support Medicare Star and other quality initiatives
What You'll Bring (Hiring Requirements)
High school diploma or GED
3+ years of experience in related field.
Active pharmacy technician license in the state of North Carolina (PTCB: Pharmacy Technician Certification Board - Nationally Accredited Certification Exam), preferred.
The position requires a work schedule from 10:00 AM to 7:00 PM, Monday through Friday.
Salary Range$47,300.00 - $66,600.00About UsIt's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.Authorization to Work in the United StatesWe use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming
