Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
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Pharmacy Technician, Quality - Hybrid
Summary of Job
Collaborate with pharmacists to proactively engage health plan members to improve their medication adherence and positively impact health outcomes. Develop and deliver communication to members that is cognizant of cultural, ethnic, and other differences in order to effectively maximize probability of success in modifying behaviors. Play a critical role in facilitating outreach efforts and ensuring timely follow-up to address barriers to adherence. Partner closely with the Quality Pharmacy Team to drive quality performance and enhance member satisfaction.
Responsibilities
- Engage with members to understand reasons for non-adherence.
- Craft and deliver empathetic, culturally sensitive, and solution-oriented support to members during outreach.
- Provide a positive member experience by reinforcing the importance of medication adherence and connecting members to appropriate resources.
- Identify barriers to adherence and support resolution of common issues such as refill delays, cost concerns, or lack of understanding of medication purpose.
- Develop and document outreach efforts while maintaining detailed and accurate records of member interactions to ensure timely and effective communication.
- Escalate clinical concerns to pharmacists as needed.
- Adhere to all regulatory, privacy, and compliance standards in member communications and data handling.
- Ensure all outreach activities are conducted in accordance with organizational policies and clinical protocols.
- Work closely with the Quality Pharmacy Team to align outreach strategies with organizational goals and quality initiatives.
- Participate in regular team huddles or strategy sessions to share insights and improve outreach effectiveness.
- Manage multiple outreach tasks and follow-ups efficiently, ensuring timely and accurate documentation.
- Prioritize work based on member needs, outreach schedules, and team objectives.
Qualifications
- Associates degree; bachelor's degree preferred.
- National Pharmacy Technician Certification required, or must be obtained within 6 months of hire date as a condition of continued employment; and certification must be maintained while employed in this role (Required)
- 3 – 5+ years of relevant, professional work experience (Required)
- 2+ years of pharmacy related experience (Required)
- 2+ years of call center customer service experience (Required)
- Additional experience / specialized training may be considered in lieu of degree requirement (Required)
- Claim system knowledge with ability to analyze pharmacy claims (Required)
- Knowledge of Medicare Part D (Required)
- Excellent communication skills with employees, practitioners and members regarding verification and explanation of pharmacy benefits (Required)
- Excellent organizational, prioritization and time management skills (Required)
- Detail oriented with strong analytical, problem solving and follow up skills (Required)
- Work independently within a team environment with/little direct supervision (Required)
- Demonstrated proficiency using personal computers, MS Office software including Word, Excel, and Access (Required)
- Ability to work in a high pace, stress environment (Required)
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.