Medicare Inbound Jobs in Minnesota (NOW HIRING)

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

The Medication Therapy Management (MTM) Service Specialist is responsible for receiving inbound and making outbound calls to qualified members across all lines of business to review the benefits of the MTM program. This position speaks with members to gather and document accurate information about the member and/or the members' medications and related disease states using the MTM Program system and processes.

Responsibilities

• Receive inbound and make outbound calls to eligible beneficiaries to schedule MTM clinician interventions in a manner that meets the specialized needs of the targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant
• Utilize Prime's MTM process management system to record member specific information
• Assess beneficiary information to ensure appropriate interaction is scheduled with appropriate MTM clinician (i.e., Pharmacist)
• Perform outreach calls to pharmacies to research contact information
• Address and triage queries regarding MTM related topics by transferring calls to MTM staff or other department help lines
• Document MTM eligibility and program status in the applicable software systems (i.e., MSA Toolbox, RX Claim)
• Other responsibilities as assigned

Minimum Qualifications

• High School diploma from an accredited school or equivalent GED
• Must be eligible to work in the United States without the need for work visa or residency sponsorship

This position a Hybrid position and will require employee to be ONSITE.

Additional Qualifications

• Has suitable home office (i.e., chair, desk, internet, etc.) that meet Prime required standards (if work from home position)
• Strong interpersonal communication skills with focus on professional demeanor and empathy
• Strong verbal and written communication and problem-solving skills
• Strong organization skills with the ability to handle multiple tasks, prioritize and meet deadlines
• Proficient in Excel, Word, and system operations (e.g. workflow processes and case management)
• Government programs (Medicare) knowledge

Preferred Qualifications

• Contact Center experience
• Pharmacy and/or PBM experience
• 1 year of experience in healthcare industry
• Experience working with highly confidential medical information
• CPhT certification
• Fluency in another language (Spanish)

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

This position a Hybrid position and will require employee to be ONSITE.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

Prime Therapeutics LLCis proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.