Remote Rn Coder Jobs in Jacksonville, FL (NOW HIRING)

Job Summary:
The FEP Quality Pharmacy Technician is a member of the Federal Employee Program (FEP) Quality team and will work with internal and external partners on clinical quality improvement initiatives related to FEP-HEDIS. Maintains organized, updated reporting of activities with clear documentation, including the tracking, monitoring and reporting out on the status of outreach resulting in FEP HEDIS care gap closure; with over-sight from a MTM Pharmacist & Registered Nurses. Conducts FEP member telephonic outreach to assist previously identified members in obtaining needed care in order to close a specific FEP HEDIS care gap. This may include speaking with the appropriate provider for the scheduling of an appointment or referring members to the FEP Care Management MTM Pharmacist and other assistance as needed to close the FEP HEDIS care gap. Conducts works to achieve better healthcare value and lower costs for our FEP members, while ensuring quality pharmaceutical care for our members.

Essential Functions:
 

• Researches and synthesizes detailed clinical data related to pharmaceuticals to identify opportunities for improving quality or close HEDIS care gaps for medication measures  
• Analyzing claims data to identify FEP members who may need MTM Pharmacist referrals.
• Performs FEP Member outreach on selected HEDIS medication measures to educate patients and caregivers on the appropriate use of medications, referring members to FEP MTM Pharmacist for more in-depth medical questions related to prescriptions. Prepares and presents data from outreach as needed for leadership. 
• Serves as pharmacy SME/representative on projects; supports internal business partners such as product development, FEP care and case managers, MTM Pharmacist, special investigations, and medical operations. Provides internal professional staff and external provider education related to pharmaceuticals and program interventions. 
• Collaborating with MTM Pharmacist, and Sr. Mgr. FEP Quality develops and coordinates member notifications for drug program opportunities pharmacy messaging campaigns.(SMS FEP Direct Outreach); Facilitate and lead assigned projects to ensure successful implementation. 
• Facilitate Care and Pharmacy integration through best practices and process improvements to optimize pharmacy care for our members.
• Perform comprehensive and targeted medication reviews to identify, resolve, and prevent medication-related problems for targeted members. 

Required Experience:
4+ years related work experience. Experience Details: Customer outreach interaction required, Pharmacy experience 
High school diploma or GED 

Pharmaceutical Claims and Diagnosis codes
Strong clinical knowledge of prescription drug products, dosage forms and drug classification types 
Demonstrated experience in patient consultative skills 
Excellent written and verbal communication skills 
Medical terminology, abbreviations and symbols 
PC skills (Word, Excel, PowerPoint and Outlook)

Required Licenses and Certifications:
CPT - Cert/Reg Pharmacy Tech 
 

General Physical Demands:
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally. 
What We Offer: 
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities. 
To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to: 
 

• Medical, dental, vision, life and global travel health insurance;
• Income protection benefits: life insurance, short- and long-term disability programs;
• Leave programs to support personal circumstances;
• Retirement Savings Plan including employer match;
• Paid time off, volunteer time off, 10 holidays and 2 well-being days;
• Additional voluntary benefits available; and
• A comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases. 
Hourly Pay Range: $21 - $35
Typical Hourly Pay Range: $21 - $27
Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.
We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.