As a Pharmacy Navigator, you will be responsible for supporting members as they navigate through their pharmacy benefits. Responsibilities include providing proactive member engagement to assist with pharmacy gaps in care, adherence concerns, costs, benefit optimization, and other initiatives. Coordinate care for those with non-optimal medication use. Collaborate with UCare departments, vendors, and other external parties to refer to additional services when needed. This role requires strong communication skills and the ability to assimilate information and data from multiple sources.

• Develop and maintain an understanding of pharmacy benefits, authorizations, the pharmacy landscape, departmental changes, and organizational initiatives to provide pharmacy-related coordination of care for UCare members.

• Work directly with members via phone, email, or other applicable means, to resolve issues, assist with concerns, and provide education and rationale for decisions. Work directly with customer services, pharmacies, providers, care coordinators, vendors, and other stakeholders to optimize care. Document interactions according to internal policies.

• Support pharmacy quality initiatives related to Star ratings, HEDIS, and population health (e.g., Assist members with medication adherence, connect members to available programs, and work with stakeholders to close gaps in care).

• Provide proactive outreach to members to notify of changes including, but not limited to, coverage determinations, formulary status changes, drug recalls, network changes, and conversion of new members to UCare formularies.

• Review internal reporting to identify members that may benefit from outreach, education, and benefit optimization.

• Respond to internal inquiries, questions, concerns, and referrals.

• Escalate clinical concerns to pharmacist staff members when necessary. Support clinical pharmacists with scheduling medication management visits and acquiring necessary documentation to support clinical work.

• Follow pharmacy department policies and procedures/work instructions to complete assigned duties.

• Other projects and duties as assigned.

Education

BA/BS preferred; demonstrated experience may be considered in lieu of degree. Pharmacy Tech CPhT preferred.

Required Experience

Two years of experience in a pharmacy or health clinic setting.

Preferred Experience

Pharmacy technician experience in a clinical or managed care setting. Experience with project coordination and customer engagement. Strong knowledge of MS office products. Bilingual proficiency preferred.

THE UCARE DIFFERENCE

The UCare difference is our people power – employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

JOB POST DATE: 11/9/2023