ConcertoHealth Inc. is the leading provider of specialized primary care and supporting clinical services for complex, frail, elderly, and dual-eligible patients. Operating exclusively in value-based agreements, ConcertoHealth provides high-touch, individualized care for patients, and deploys wraparound clinical resources to extend the reach of primary care practices. This comprehensive medical management solution, elevated by Concerto’s proprietary population health technology, improves overall healthcare quality and patient outcomes, benefitting payers and their provider networks. The company is headquartered in Irvine, Ca. For more information, please visit www.concertohealth.com.
Assists pharmacists and providers with medication-related functions, reporting and processes.
· Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations
· Medication adherence outreach, auditing, documenting and reporting as it pertains to STAR measures
· Assist in opioid overutilization outreach and documentation based on OMS state reports
· Perform basic medication reconciliation with patients telephonically or face to face
· Assist with prior authorization requests from providers and pharmacy benefit manager
· Process in-person and phone requests for prescription refills, determine if requests require approval, retrieve patient record if needed, collate and/or route requests electronically, in writing, or by facsimile to the Medical Provider or authorizing entity per request
· Triage in-person, written, or phone requests for drug information or health advice to a registered pharmacist or to an appropriate entity within the health organization
· Assist in auditing of medication related HEDIS measures
· Troubleshoot prescription third party claim rejections by understanding formulary restrictions, plan limitations, drug utilization review override codes, relationship codes; requesting and completing prior authorization forms; and/or communicating with plan help desk representatives and prescribing entity
· Document on log sheets pharmaceutical inventory issued to floor stock, return to manufacturer, or items mark to be destroyed, as well as, auditing to ensure inventory is properly stored, maintained and organized.
· Compare received pharmaceutical stock and supplies with invoices in collaboration with lead medical assistant at each clinic
· Assist pharmacist with MTM (medication therapy management) preparation
· Assist in day to day tasks as needed and requested by lead pharmacist
· Responsible for interacting with other departments to assist with member problems or questions and act as facilitator to resolve them
· Attend scheduled team meetings and provide relevant feedback in regards to workflow issues
Graduated from an accredited pharmacy technician program. Three or more years experience as a Pharmacy Technician - pharmacy benefit management experience preferred. Current MI State Pharmacy Technician Certification and License required. Experience and/or ability to work with electronic health record systems.