Job Details

Service Specialist - Mtm

Our work matters. We help people get the medicine they need to feel better and live well. It fuels our passion and drives every decision we make.

The Medication Therapy Management (MTM) Service Specialist is responsible for receiving inbound and making outbound calls to qualified members across all lines of business to review the benefits of the MTM program. This position speaks with members to gather and document accurate information about the member and/or the members' medications and related disease states using the MTM Program system and processes.

Responsibilities include:

• Receive inbound and make outbound calls to eligible beneficiaries to schedule MTM clinician interventions in a manner that meets the specialized needs of the targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant
• Utilize Prime's MTM process management system to record member specific information
• Assess beneficiary information to ensure appropriate interaction is scheduled with appropriate MTM clinician (i.e., Pharmacist)
• Perform outreach calls to pharmacies to research contact information
• Address and triage queries regarding MTM related topics by transferring calls to MTM staff or other department help lines
• Document MTM eligibility and program status in the applicable software systems (i.e., MSA Toolbox, RX Claim)
• Other responsibilities as assigned

Minimum qualifications:

• High School diploma from an accredited school or equivalent GED
• 1 year of work experience in customer service
• Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional qualifications:

• Has suitable home office (i.e., chair, desk, internet, etc.) that meet Prime required standards (if work from home position)
• Strong interpersonal communication skills with focus on professional demeanor and empathy
• Strong verbal and written communication and problem-solving skills
• Strong organization skills with the ability to handle multiple tasks, prioritize and meet deadlines
• Proficient in Excel, Word, and system operations (e.g. workflow processes and case management)
• Government programs (Medicare) knowledge

Preferred qualifications:

• Contact Center experience
• Pharmacy and/or PBM experience
• 1 year of experience in healthcare industry
• Experience working with highly confidential medical information
• CPhT certification
• Fluency in another language (Spanish)

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer.