GlobalHealth, Inc.
Pharmacy STARS Specialist (49032)
GlobalHealth, Inc., Oklahoma City, Oklahoma, United States, 73116
Overview
GlobalHealth is a fast‑growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine Care and Optimal Health for the members we serve. We are unique by providing high‑touch, high‑value and a partnership to our members. We go above and beyond to provide personalized, engaging, and responsive services to our members. We offer affordable health insurance coverage with benefits people truly want and need, and we aim to be more than just an insurance company, becoming long‑term partners with our members. Description
Performs tasks associated with quality initiatives to improve member care. Ensures the effective management of medication adherence, including data entry, member status monitoring, call tracking, and telephonic member/provider outreach. Essential Job Functions
Supports and maintains outreach initiatives with members and providers. Effectively educates Medicare members to enhance patient compliance and support quality metrics. Performs accurate data entry in the outreach tracking system. Reviews and maintains prescription records to identify and confirm medication adherence. Educates providers on quality metric guidelines to enhance patient compliance on an as‑needed basis. Maintains a strong working knowledge of STARS measures set by CMS performance standards. Maintains confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. Performs other duties as assigned. Qualifications
High School diploma or equivalent required. Current Certified Pharmacy Technician or one year of experience with a health plan, medication adherence or within a quality department or pharmacy. Knowledge, Skills, and Abilities
Computer literate and familiar with Microsoft applications (Word, Excel). Basic electronic health record knowledge and ability to quickly learn new software. Detailed knowledge of quality performance measures and clinical health care. Strong organizational and time‑management skills. Strong verbal and written communication skills. Work Environment
Current work environment is remote; however, some state exclusions apply. Must have access to a reliable and secured internet connection source. The position must maintain confidentiality of business information, including PHI, as required by HIPAA and company policy. Reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and adherence to all GlobalHealth privacy and security policies are required. Travel
Travel is not required for this position. Supervisory Responsibility
This position has no supervisory responsibilities. Other Duties
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Seniority level
Entry level Employment type
Full‑time Job function
Health Care Provider Industries
Hospitals and Health Care
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GlobalHealth is a fast‑growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine Care and Optimal Health for the members we serve. We are unique by providing high‑touch, high‑value and a partnership to our members. We go above and beyond to provide personalized, engaging, and responsive services to our members. We offer affordable health insurance coverage with benefits people truly want and need, and we aim to be more than just an insurance company, becoming long‑term partners with our members. Description
Performs tasks associated with quality initiatives to improve member care. Ensures the effective management of medication adherence, including data entry, member status monitoring, call tracking, and telephonic member/provider outreach. Essential Job Functions
Supports and maintains outreach initiatives with members and providers. Effectively educates Medicare members to enhance patient compliance and support quality metrics. Performs accurate data entry in the outreach tracking system. Reviews and maintains prescription records to identify and confirm medication adherence. Educates providers on quality metric guidelines to enhance patient compliance on an as‑needed basis. Maintains a strong working knowledge of STARS measures set by CMS performance standards. Maintains confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. Performs other duties as assigned. Qualifications
High School diploma or equivalent required. Current Certified Pharmacy Technician or one year of experience with a health plan, medication adherence or within a quality department or pharmacy. Knowledge, Skills, and Abilities
Computer literate and familiar with Microsoft applications (Word, Excel). Basic electronic health record knowledge and ability to quickly learn new software. Detailed knowledge of quality performance measures and clinical health care. Strong organizational and time‑management skills. Strong verbal and written communication skills. Work Environment
Current work environment is remote; however, some state exclusions apply. Must have access to a reliable and secured internet connection source. The position must maintain confidentiality of business information, including PHI, as required by HIPAA and company policy. Reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and adherence to all GlobalHealth privacy and security policies are required. Travel
Travel is not required for this position. Supervisory Responsibility
This position has no supervisory responsibilities. Other Duties
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Seniority level
Entry level Employment type
Full‑time Job function
Health Care Provider Industries
Hospitals and Health Care
#J-18808-Ljbffr