Healthcare Program Associate:

Summary:

The candidate should possess a professional approach to all aspects of their work; be able to effectively communicate verbally and in writing with internal and external stakeholders regarding Medicaid Pharmacy program and specific benefits; research and document Medicaid Pharmacy policy; appropriately direct calls from Elderly Pharmaceutical Insurance Program (EPIC) recipients; have strong organizational skills; be able to multitask and deliver on tight timeframes; have the ability to work collaboratively with co-workers and be self-motivated. 

Preferred candidates will have experience in a healthcare field, preferably pharmacy or pharmacy benefits; performing administrative and clerical tasks and managing files, supporting other staff members with organizational tasks; ability to provide assistance to phone inquiries and emails; ability log and maintain reporting of such per the processes provided. The candidates should be able to make sophisticated judgements concerning Pharmacy Policy as provided in Manuals and guidance; handling phone inquiries and interpreting and providing guidance on policy. The candidate should have experience using Microsoft applications including Outlook, Word and Excel.

Phone/email tasks:

• • Gather enough information to be able to triage calls and escalate direct patient care issues or respond directly using the guidance provided.
  • Utilize eMedNY to screen pharmacy issues that result from enrollment errors and provide the appropriate contact number to the caller.
  • Check phone log while caller is on the line, to determine if the call is related to a previously logged issue and, if applicable, give the caller an update on the issue based on the information in the log.
  • When call is taken from VM, call back and obtain all necessary information needed to assist.
  • Route requests for PA to the correct phone number.
  • Promptly responds to incoming inquiries.
  • Monitor fax inbox (473-5508) for pharmacy related items and forward to appropriate staff in a timely manner.
  • Monitor Pharmacy mailbox (PPNO) and assist with responses to inquiries.
  • Assist with Emergency Services Only requests – review and request any additional required information in a timely manner; file and log completed requests.
  • Assistance with issues caused by Medicaid member or provider enrollment errors - emails can be sent directly to applicable enrollment area for resolution.
  • Suggest topics for eBlasts and Medicaid Update articles based on topic phone volume.
  • Review pharmacy policy documents and manual for areas needing updates; submit to appropriate staff for review/changes.
  • Assist with scheduling/coordinating internal and external meetings for Pharmacy staff.
  • Update Pharmacy Policy documents for Medicaid Update articles; schedule and track documents for review by professional staff on an annual basis.

Basic Qualifications:

• 2 years’ experience in the healthcare field
• An associate degree can count as 2 years of experience, a bachelor’s degree can count as 4 years of experience, and a master’s degree can count as 5 years of experience

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides the following reasonable range of compensation for this role: $19.00 hr. - $22.00 hr. In addition, SSO provides a range of benefits for this role.

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.