* Monitor phone queue and answer calls generated by members/providers. Forward higher complexity and/or clinical member/provider inquiries to DTM pharmacist or DTM Department Manager as appropriate.
* Assign interactive consultation requests to clinical staff for member calls generated through queue.
* Perform and document member general history assessment utilizing the DTM application; document patient comments and inquiries; and review and update member demographics.
* Fax or mail interactive consultations to members and providers which have been completed by clinical staff.
* Follow-up on member/provider outreaches to determine outcomes. Document outcomes in appropriate databases.
* Proficient in use of JIVA and PerformPRO, including: ability to document in both systems utilizing established workflow processes, send letters to members and providers through PerformPRO, and complete items in task queue for both DTM & MTM. Audits mailings prior to delivery.
* Ensure DTM task queue is up-to-date and technician tasks are completed within a timely manner.
* Follow established process workflows for inbound/outbound calls generated within department.
* Administer ASK-12 surveys to members and provide responses to a pharmacist for review. Forward complex cases to a pharmacist for consultation.
* Provide suggestions for system enhancements to appropriate staff to improve process & productivity.
* Administratively supports the DTM Area. Performs varied administrative duties inclusive of handling correspondence, maintaining calendars and mailboxes, scheduling meetings, ordering meals for meetings, preparing agendas and payment of consultants.
* Report issues with PerformPRO application to DTM Department Manager and/or Business Solutions.
* Utilize RxFocus to run general member/provider demographic reports.
* Forward member inquiries outside scope of DTM to appropriate resource utilizing call tree.
* Comply with CMS & URAC MTM/DTM Standards.
* High School Diploma or equivalent required; Associate's degree preferred
* Current National Pharmacy Technician Certification (PTCB, NCCT or ExCPT) required
* Minimum three (3) years healthcare experience
* Managed care experience preferred
* Medication Therapy Management training preferred