Representative, Medication Therapy Management Services ...

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 u2022 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. u2022 Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. u2022 Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. u2022 Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. u2022 Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. u2022 Utilizes appropriate resources to ensure member contact information is current and up-to-date. u2022 Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. u2022 Interacts with appropriate primary care providers to ensure member registry is current and accurate. u2022 Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. u2022 Proactively identifies ways to improve member relations. u2022 Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications u2022 At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. u2022 Excellent customer service skills. u2022 Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. u2022 Ability to multi-task applications while speaking with members. u2022 Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. u2022 Ability to meet established deadlines. u2022 Ability to function independently and manage multiple projects. u2022 Excellent verbal and written communication skills, including excellent phone etiquette. u2022 Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications u2022 Health care industry experience. u2022 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.

Created: 2025-10-06