Pharmacy Tech (Pharmacy Care Coordinator) - Evernorth - California

Pharmacy Tech (Pharmacy Care Coordinator) - Evernorth - California

Summary:

The Pharmacy Care Coordinator helps analyze client data to identify members that would benefit from Evernorth intervention, contact members and execute select intervention activity. Interventions include, but are not limited to, recommending low-cost pharmacy options, assessing member’s drug therapy readiness, educating and referring members on potential point solutions offerings and coordinating conversations with internal clinician partners.

The primary focus of this position is to direct employees to the maximum use of their benefits, establish relationships, coordinate care, advocate for the employee, provide wellness and health promotion services and patient education.

Description:

The Pharmacy Care Coordinator supports quality, safety, and trend initiatives within the Evernorth Workplace Care department.  Their primary focus is to execute a specific basket of interventions on a given client population.  The role will require both member facing and client facing activity.  The Pharmacy Care Coordinator will also serve as a liaison to a variety of internal and external teams, provides timely responses to inquiries, and maintains a record of activities and results, as appropriate. 

The Pharmacy Care Coordinator works well independently, as well as collaboratively including with account teams to ensure clients and their members receive superior service. 

Responsibilities include:

• Conduct comprehensive appraisals of patient’s health status by taking health histories and drug histories

• Work with care team to execute therapeutic plans using the most clinical and economically effective medication treatment per protocol or clinical guidelines.

• Evaluate and document patients’ and caregivers’ ability to understand medication instructions and provide oral education on their medications.

• Provide patient education and medication information.

• Use multiple data analytics programs that provide the patient/member on:

• Medication compliance

• Chronic Condition support

• Physician referrals

• Referral to Case Management for authorization assistance

• Retail/mail order and benefit questions

• Assist on any customized projects and outreach for the Client served.

  • Example: promotion of generic and formulary prescribing and advising on formulary changes, etc.  

• Analytics programs that will improve clinical and financial outcomes and support trend management include:

  • Customer Service Platform /Portal (f/k/a Service Delivery); read-only holistic view into transactional history

  • Health Connect 360 Care Insight Hub – no codes – just engagement – identification of clinical opportunities

  • HealthEview – view into coaching and claims history

  • TRC tool – better documentation potential – has codes that might be able to generate reporting

  • Intellisphere – more identification/holistic data  

• Document activity in available tools, working with the analytics team to track outcomes both clinically and financially.

• Empower customers to become an active participant in their own health outcomes. 

• Assist Customer in overcoming barriers to overall better health.

• Act as onsite Benefits Champion: Participate in monthly benefits training program to better triage patient/customer to the right resources and services, such as connecting them to other services including tobacco cessation, nutrition education, etc.

• Proactively create a culture of personal health and responsibility through the development, distribution, delivery and posting of educational materials using available distribution/posting resources.

• Effectively participate in staff meetings and with matrix partners to share best practices, improve processes.

• Collaborate with our matrix partners to support the overall health and wellness strategy of the aligned client. 

Qualifications:

• Current Certified Pharmacy Tech (CPht) License is strongly preferred OR at least a minimum of 3 or more years clinical experience with pharmaceuticals

• At least 2 or more years of general pharmacy experience; 2 or more years in managed care, the PBM industry, or pharmaceutical sales preferred

• Ability to establish and maintain patient relationships.

• Excellent verbal, presentation, and written communication skills required.

• Proven leadership skills, team-orientation, a proactive management style a