Regence Blue Shield Remote Jobs (NOW HIRING)

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

*This role is designated as a teleworker position; however, preference will be given to applicants located in Minnesota*

The Impact you will have

The purpose of this position is to improve population-based and member specific medication related outcomes. As part of the Medication Therapy Management (MTM) and pharmacy quality team, you will work closely with our members, their pharmacies and care teams to optimize medication regimens. This includes working with members at risk for non-adherence, those at high risk for adverse events from their medications due to multiple co-morbid conditions, and polypharmacy. This position will receive targeted member lists, perform outreach to those members, with the intention of ensuring members are consistently adherent to their medications, including scheduling an appointment with the MTM pharmacist.

Your Responsibilities

• Support pharmacists by pre-charting and reviewing pharmacy claims information to assist with member outreach

• Conduct outbound calls for refill reminders, adherence checks, and follow-up.

• Assist with medication reconciliation by loading prescription claims and medication administration records into a member's medication list within an electronic health record.

• Document clinical responses from member outreach within an electronic health record to track interventions and medication adherence issues.

• Schedule comprehensive medication management visits with pharmacists for members who have multiple medications/chronic conditions, including cross departmental referrals.

• Participate in other population health-based interventions that impact Star Ratings and/or HEDIS quality measures.

Required Skills and Experiences

• 5+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

• Current Pharmacy Registration and Certification (Certified Pharmacy Technician)

• At least 5 years of experience in ambulatory care/clinic/outpatient pharmacy, discharge, or health plan quality setting

• Clear knowledge of the top 100 commonly prescribed medication names and classes

• Experience researching medication claims history and/or escalations

• Direct patient care experience and/or customer service experience

• Microsoft/Outlook experience

• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experiences

• Experience and knowledge working with MTM program(s) in a clinic/retail setting

• Experience with Medicare Star Ratings and HEDIS Quality measures

• Excellent verbal and written communication skills

• Epic electronic health record experience

• Learns quickly and adapts to change

• Acquires and maintains high accuracy and attention to detail

Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite.

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance

• Life insurance

• 401k

• Paid Time Off (PTO)

• Volunteer Paid Time Off (VPTO)

• And more

To discover more about what we have to offer, please review our benefits page.

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.