As a Therapy Representative, you will be a key member of a Specialty Pharmacy by enhancing our members experience within their specific health plan. The purpose of this Adherence role is to provide expertise and customer service to our valued AI members or providers relating to enrollment, refilling of prescription orders, discussing benefits, and any/all other questions in regards to their health plan. Required Qualifications6+ months experience as a Patient Service Representative or similar role in the healthcare industry. Must meet pharmacy technician licensing requirements for the state which you are working in.
The primary responsibility of the Therapy Adherence Liaison role is to act as a patient advocate in addressing patient concerns to drive adherence and compliance. This candidate in this position will coordinate with sales, CRU, reimbursement and operations to manage the patient medication needs. Adherence Liaisons will be required to triage issues to the appropriate departments and update the patients accordingly. Proactively Communicate Compliance/Adherence related concerns to patients to mitigate disruption in patient therapy. Therapy Adherence Liaisons are considered retention specialists to help ensure patient adherence and prescription compliance going forward.
Initiates communications (multiple phone calls) with patients to resolve any CVS Health related concern related to patient medication needs. Read notes in preparation of call to determine possible problems/solutions.
Determine reasons patient is not compliant with therapy and offer solutions to assist in ongoing adherence
Coordinate between departments to bring patients back into compliance
Respond to internal inquiries via phone, email and/ or facilitate conference calls with appropriate departments as needed. Reporting requirements to various leaders on activity/results.
Initial responsibility for Prior Authorization and Expiring prescription management including collating data and providing to the medical offices/centers as requested. Once refill reactivated, the refill team handles future orders (unless adherence is disrupted again). ?xml:namespace prefix = "o" ns = "urn:schemas-microsoft-com:office:office" /
Two years experience as a Customer Service Representative or similar role in the healthcare industry. EducationVerifiable High School Diploma or GED is required Business Overview
1. Knowledge of disease therapy and the moving parts of patient medication management.
2. In depth knowledge of co-pay assistance programs.
3. Full knowledge of Specialty Pharmacy Operations systems, processes and procedures including CRU/
SGM teams and reimbursement (billing and coordination of benefits).
4. Demonstrated ability to independently troubleshoot and problem solve complicated issues
5. Mastery of effective customer service skills including patient advocate focus.
6. Excellent proven interpersonal skills with the ability to teach and motivate others.
7. Self-starter with solid work ethic, organizational and prioritization skills.
8. Excellent verbal and written communication skills including ability to communicate effectively with all levels of management.
9. Proficient with Microsoft Office (Excel, Outlook, PowerPoint and Word) ?xml:namespace prefix = "o" ns = "urn:schemas-microsoft-com:office:office" /
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
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