Contact Center/Call Center
Sign on Bonus: $1,500Shift: Friday-Tuesday or Saturday-Wednesday
Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. This position requires a OH Board of Pharmacy certification.
CarelonRx Pharmacy is now part of CarelonRx (formerly IngenioRx), a proud member of the Elevance Health family of companies. The CarelonRx Home Delivery Pharmacy will deliver a digital first pharmacy experience that is convenient, simpler to use, and more affordable for our patients and payors. Our Pharmacy model focuses on whole person care, providing the best member experience to drive adherence, affordability, and improved overall health outcomes by putting the patient first. Our CarelonRx Pharmacy locations are newly built out, modern facilities with employee friendly amenities.
What We Offer:
- Stable Work Schedules: Say goodbye to hour cuts and swing shifts. We value work life balance.
- Comprehensive Patient Care: Ensuring you make a difference in the lives of those you serve.
- Supportive Team Environment: Collaborate with a passionate and caring team dedicated to your success.
The Pharmacy Tech I is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues, and responding to customer questions via telephone and written correspondence regarding pharmacy prescriptions.
How to make an impact:
- Develops and maintains positive customer relations and coordinates internally to ensure customer requests are handled and resolved appropriately and in a timely manner.
- Completes necessary research using multiple systems to provide proactive, thorough solutions.
- Displays ownership of service requests ensuring high quality resolution.
- Handles various outbound communications via telephone and written correspondence.
- Troubleshoot and assist with adjudication errors as needed.
- Update patient profiles and collect payments as needed.
- Verifies member information and inputs data for the pharmacists.
- Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.
- Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
- Provides resolution to grievances and appeals issues.
- Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
- Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
- Maintains record keeping of prior authorizations, rebates, and monthly reports.
- Requires H.S. diploma or equivalent and minimum of 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
- Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.
Preferred Capabilities, Skills, and Experiences:
- Experience in high volume mail order or specialty pharmacy preferred.
- Expereince in high volume call center/customer service preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills .
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact email@example.com assistance.