MCS Puerto Rico
Pharmacy Call Center & Coverage Deter Team Leader
MCS Puerto Rico, San Juan, San Juan, us, 00902
Pharmacy Call Center & Coverage Deter Team Leader
1 week ago Be among the first 25 applicants GENERAL DESCRIPTION:
Responsible for assisting and monitoring operational processes for Pharmacy Technicians in their delegated tasks, such as identifying potential errors or gaps in information during the coverage determination process. Identifies training and retraining needs for staff to ensure efficiency and compliance with regulatory agencies. Regular Non-Exempt GENERAL DESCRIPTION:
Responsible for assisting and monitoring operational processes for Pharmacy Technicians in their delegated tasks, such as identifying potential errors or gaps in information during the coverage determination process. Identifies training and retraining needs for staff to ensure efficiency and compliance with regulatory agencies. ESSENTIAL FUNCTIONS: Act as an expert resource to assist Pharmacy Technicians in their processes and provide advice on situations they bring to their attention. Identify errors in information, processes, and timing related to Pharmacy Technician calls, as well as gaps in information during the coverage determination process, and report findings to management for appropriate action. Assist in task assignments, set priorities, and monitor unit goals while ensuring processes are executed following regulations, instructions, and company policies. Identify training and re-training needs and suggest implementation plans to ensure efficiency and compliance with regulatory agencies. Re-trains the Pharmacy Technician about operational, regulatory changes, or instructions given by the management. Recommend to the management improvements to existing processes to meet quality standards established by the department. Identify patterns of inappropriate behavior and promptly notify management. These patterns may include attendance issues, punctuality concerns, employees being away from their designated work areas, non-work-related matters, and non-compliance with company policies and procedures. Additionally, this role involves Address Pharmacy Utilization Management email referrals as needed. Assist management with internal and external monitoring of the unit. Represents the Unit and Specialized Pharmacy Programs in meetings. Tracks case metrics to validate project outcomes and manages reports. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. MINIMUM QUALIFICATIONS: Education:
Technical or Associate Degree in Pharmacy Assistant. At least two (2) years of experience working in a Pharmacy Call Center, or participating in clinical evaluation processes, pharmacotherapeutic monitoring, or activities related to medication review, preferably in the Healthcare Industry. Certifications / Licenses:
An Active Pharmacy Assistant License and Registration is required. Other: Proficiency in ICD-10 clinical criteria and/or CPT procedure codes. Languages:
Spanish – Intermediate (comprehensive, writing, and verbal); English – Intermediate (comprehensive, writing, and verbal) “Somos un patrono con igualdad de oportunidad en el empleo y tomamos Acción Afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimento” Seniority level
Entry level Employment type
Full-time Job function
Health Care Provider Industries Insurance Referrals increase your chances of interviewing at MCS Puerto Rico by 2x Pharmacy Technician / Pharm Tech Apprenticeship
San Juan, Puerto Rico $17.50-$21.00 4 weeks ago Pharmacy Technician / Pharm Tech Apprenticeship
Guaynabo, Puerto Rico $17.50-$21.00 2 weeks ago Bilingual Rx Customer Service Specialist (Seasonal)
Pharmacy Technician / Pharm Tech Apprenticeship
Carolina, Puerto Rico $17.50-$21.00 6 days ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
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1 week ago Be among the first 25 applicants GENERAL DESCRIPTION:
Responsible for assisting and monitoring operational processes for Pharmacy Technicians in their delegated tasks, such as identifying potential errors or gaps in information during the coverage determination process. Identifies training and retraining needs for staff to ensure efficiency and compliance with regulatory agencies. Regular Non-Exempt GENERAL DESCRIPTION:
Responsible for assisting and monitoring operational processes for Pharmacy Technicians in their delegated tasks, such as identifying potential errors or gaps in information during the coverage determination process. Identifies training and retraining needs for staff to ensure efficiency and compliance with regulatory agencies. ESSENTIAL FUNCTIONS: Act as an expert resource to assist Pharmacy Technicians in their processes and provide advice on situations they bring to their attention. Identify errors in information, processes, and timing related to Pharmacy Technician calls, as well as gaps in information during the coverage determination process, and report findings to management for appropriate action. Assist in task assignments, set priorities, and monitor unit goals while ensuring processes are executed following regulations, instructions, and company policies. Identify training and re-training needs and suggest implementation plans to ensure efficiency and compliance with regulatory agencies. Re-trains the Pharmacy Technician about operational, regulatory changes, or instructions given by the management. Recommend to the management improvements to existing processes to meet quality standards established by the department. Identify patterns of inappropriate behavior and promptly notify management. These patterns may include attendance issues, punctuality concerns, employees being away from their designated work areas, non-work-related matters, and non-compliance with company policies and procedures. Additionally, this role involves Address Pharmacy Utilization Management email referrals as needed. Assist management with internal and external monitoring of the unit. Represents the Unit and Specialized Pharmacy Programs in meetings. Tracks case metrics to validate project outcomes and manages reports. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. MINIMUM QUALIFICATIONS: Education:
Technical or Associate Degree in Pharmacy Assistant. At least two (2) years of experience working in a Pharmacy Call Center, or participating in clinical evaluation processes, pharmacotherapeutic monitoring, or activities related to medication review, preferably in the Healthcare Industry. Certifications / Licenses:
An Active Pharmacy Assistant License and Registration is required. Other: Proficiency in ICD-10 clinical criteria and/or CPT procedure codes. Languages:
Spanish – Intermediate (comprehensive, writing, and verbal); English – Intermediate (comprehensive, writing, and verbal) “Somos un patrono con igualdad de oportunidad en el empleo y tomamos Acción Afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimento” Seniority level
Entry level Employment type
Full-time Job function
Health Care Provider Industries Insurance Referrals increase your chances of interviewing at MCS Puerto Rico by 2x Pharmacy Technician / Pharm Tech Apprenticeship
San Juan, Puerto Rico $17.50-$21.00 4 weeks ago Pharmacy Technician / Pharm Tech Apprenticeship
Guaynabo, Puerto Rico $17.50-$21.00 2 weeks ago Bilingual Rx Customer Service Specialist (Seasonal)
Pharmacy Technician / Pharm Tech Apprenticeship
Carolina, Puerto Rico $17.50-$21.00 6 days ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr