As a Clinical Operations Pharmacy Technician, you will support primary care physicians, clinics and patients by executing programs developed to improve overall health outcomes with a focus on prescription drugs and medication therapy. (HEDIS medication adherence) You will assist in driving prescription drug optimization in cases where patients are taking multiple medications.
The Clinical Operations Pharmacy Technician will be responsible for the lifecycle management of chronic disease medications. This role focuses on maximizing the Proportion of Days Covered (PDC) by identifying and resolving barriers to adherence before they result in a gap in care.
Key Responsibilities:
Data Tracking (PDC gap lists) Perform varied activities and moderately complex administrative,
Operational, customer support assignments.
Make outbound and take inbound calls.
Patient outreach MyCare Medical members.
Collect medication history information and identify Barriers (access, side effects, cost)
Ensure prescriptions are refilled and picked up timely by the member and synchronize medications
Communicate with Pharmacies regarding refills
Utilize Payor Portals
Proactive "Leads" Management: Review EMR alerts and PDC gap lists daily to initiate outreach 14–21 days prior to a patient's expected "run-out" date.
Medication Synchronization: Actively coordinate with retail and mail-order pharmacies to align multiple chronic medications to a single 100-day refill cycle.
Physician Liaison: Flag clinical barriers (e.g., side effects or therapeutic duplication) to the PCP to facilitate script adjustments, ensuring the patient doesn't simply abandon therapy.
Qualifications::
Resident State Pharmacy Technician License OR National Pharmacy Technician Certification.
High School Diploma or equivalent.
Excellent communication skills both written and verbal.
Applied knowledge of HEDIS, medication adherence, insurance processing, customer service or call center processes and practices.
Strong analytical skills with the ability to interpret PDC reports and prioritize patient lists based on 'impact ability'."
Familiarity with Medicare Advantage Star Ratings and the impact of Triple-Weighted HEDIS measures (Diabetes, Hypertension, Cholesterol)."
Requirements:
Pharmacy Technician Certification
Ability to speak both English and Spanish fluently.
Remote: will train onsite at CBO Lutz Fl for 1 week
You must be on time, dressed appropriately
HEDIS knowledge and previous experience with Medication Adherence Guidelines
Preferred Qualifications:
Experience in mail order and/or retail pharmacy setting.
Strong communication and telephonic skills.
Ability to solve problems and encourage others in collaborative problem solving.
Self-directed, but also able to work well in a group.
A positive, proactive attitude, energetic, highly motivated and a self-starter.
Work ethic that is focused, accurate and highly productive.
Strong attention to detail and accuracy
Excellent communication and customer service skills
Ability to work in a fast-paced environment
Basic math and computer skills
Knowledge of pharmacy software systems (e.g., EMR)
Success Measures:
Monthly PDC Target: Maintain a panel adherence rate of >80% for assigned members.
Documentation: 100% of outreach attempts and barrier resolutions documented in the EMR within 24 hours.
Benefits and Details:
Comprehensive benefits package, including Health, Vision, Dental, and Life insurances
PTO Accrual and Holidays
401(k) retirement savings plan.
Short-term and long-term disability.
FSA and Life Assistance Program (EAP)
Health Advocacy, Travel Assistance, and My Secure Advantage
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