About this role
Support the clinical team by delivering MTM (Medication Therapy Management) services through triage, documentation, and outreach. You will assist with CMR (Comprehensive Medication Reviews) preparation, support DUR (Drug Utilization Review) initiatives, and help prepare documentation for regulatory audits while ensuring CMS compliance.
Key Responsibilities
- Provide MTM services via triage of inbound calls and fax monitoring
- Support pharmacists with CMR pre-work up and case preparation
- Engage in DUR by preparing for initiatives and conducting telephonic outreach and letter campaigns
- Document services/activities in databases/software to meet CMS requirements
- Support preparation and documentation for responses to regulatory audits tied to over utilization program
Technical Overview
The role focuses on medication program operations rather than software engineering: handling MTM hotline triage, monitoring fax lines for prescriber responses, supporting CMR pre-workup and case preparation, and assisting DUR initiatives via outreach and campaigns. Documentation in databases/software is required for CMS requirements and audit response support.
Ideal Candidate
The ideal candidate is an entry-level pharmacy technician with High School or GED and 0-1 year of experience in pharmacy operations within managed care, hospitals, and/or retail settings. They are comfortable performing MTM triage, supporting CMR pre-workup and case preparation, participating in DUR initiatives, documenting activities to meet CMS requirements, and communicating with pharmacies, prescribers, and beneficiaries.
Must-Have Skills
High School or GED required0-1 year of experience in pharmacy operations managed carehospitalsand/or retail environmentsCertified Pharmacy Technician (CPhT) Preferred (not required)
Nice-to-Have Skills
Pharmacy operations experience in managed carehospitalsand/or retail environments (0-1 year acceptable as requirementbut listed as experience context)Certified Pharmacy Technician (CPhT)
Tools & Platforms
MTM hotline (fax line and hotline operations)databases/software (unspecified)
Required Skills
medication therapy management (MTM) servicestriage of inbound calls to MTM hotlinemonitor fax linefailed faxes completion supportComprehensive Medication Reviews (CMRs) pre-work upcase preparationcommunicate with network pharmaciesprescribers and beneficiariesdrug utilization review (DUR) supportmeeting preparationletter campaignstelephonic outreachbasic data analytic activitiestracking of interventionsregulatory audits responses preparation and documentationCMS requirements compliancedocumentation in databases/software
Hard Skills
medication therapy management (MTM)triage of inbound calls to MTM hotlinefax line monitoringfailed faxes completion supportComprehensive Medication Reviews (CMRs)pre-work up and case preparationcommunication with network pharmaciescommunication with prescriberscommunication with beneficiariesdrug utilization review (DUR)execution of DUR initiativesmeeting preparationletter campaignstelephonic outreachbasic data analytic activitiestracking of interventionsregulatory audit responses preparation and documentationCMS requirements complianceclinical service offerings compliance documentationdocumentation and records in databases/softwaremedication-related problems resolutionevidence-based drug selection
Soft Skills
collaboration with prescribersbeneficiary communicationempathetic communicationattention to detailability to resolve medication-related problemstelephonic communicationcase preparation organization
Certifications
Preferred
Certified Pharmacy Technician (CPhT)
Keywords for Your Resume
Pharmacy Technician Care Advocatepharmacy techniciancare advocatemedication therapy managementMTMMTM hotlinefax linefailed faxesComprehensive Medication ReviewsCMRspre-work upcase preparationnetwork pharmaciesprescribersbeneficiariesdrug utilization reviewDURdrug utilization review initiativesmeeting preparationletter campaignstelephonic outreachdata analytic activitiestracking of interventionsregulatory auditsCMS requirementsclinical service offeringsCertified Pharmacy TechnicianCPhT8-5 ESTPharmacy TechnicianMedication Therapy ManagementDrug Utilization Review
Deal Breakers
High School or GED required, 0-1 year of experience in pharmacy operations managed care, hospitals, and/or retail environments
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