Lider del Centro de Llamadas de Farmacia y Determinaciones
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.
- Assists in task assignments, sets priorities, and monitors unit goals while ensuring processes are executed following regulations, instructions, and company policies.
- Identifies training and re-training needs and suggests 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.
- Recommends to the management improvements to existing processes to meet quality standards established by the department.
- Identifies patterns of inappropriate behavior and promptly notifies 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)
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