POSITION SUMMARY
This position will be responsible for supporting medication adherence initiatives for Medicare Advantage members by coordinating outreach efforts with medical providers, pharmacies, and members. This role focuses on identifying and addressing medication adherence gaps, ensuring members obtain prescribed medications, and maintaining accurate documentation of outreach activities. The coordinator plays an important role in improving medication adherence rates and supporting overall quality performance measures.
ESSENTIAL DUTIES & RESPONSIBILITIES
- Conduct initial outreach phone calls to medical providers and pharmacy providers to notify them of open medication adherence gaps for Medicare Advantage members.
- Send reminder email notifications to providers and pharmacies regarding medication adherence gaps that remain unresolved.
- Perform follow-up phone outreach to providers and pharmacies to ensure awareness and action regarding adherence gaps.
- Contact pharmacies and/or members to confirm that prescribed medications have been picked up.
- Maintain accurate logs and documentation of all outreach attempts and communications.
- Track and update adherence outreach activities in internal systems and spreadsheets.
- Utilize Microsoft Excel to track outreach activities, adherence status, and reporting metrics.
- Collaborate with internal teams to support medication adherence programs and quality improvement initiatives.
- Ensure all outreach and documentation activities comply with Medicare Advantage program requirements and organizational policies.
QUALIFICATIONS & EDUCATION
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- High school diploma or equivalent required; Associate’s or bachelor’s degree in healthcare administration, Pharmacy, Public Health, or a related field preferred.
- 1–3 years of experience in healthcare, pharmacy operations, managed care, or Medicare Advantage preferred.
- Experience working with providers, pharmacies, or healthcare outreach programs is a plus.
- Proficiency in Excel is required.
- Strong communication and phone outreach skills.
- Ability to interact professionally with providers, pharmacy staff, and members.
- Strong organizational and documentation skills with attention to detail.
- Proficiency in Microsoft Excel and Microsoft Office Suite.
- Ability to track multiple outreach activities and follow up effectively.
- Knowledge of Medicare Advantage or medication adherence programs is preferred.
WORK CONDITIONS
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- The noise level in the work environment is usually moderate.
- fast-paced office environment.
- Highly regulated environment.
- Time frames to handle issues are in accordance with CMS and NCQA as well as internal time frames.
- Interacts with providers, staff, visitors, government agencies, etc., under a variety of conditions and circumstances.
This work requires the following physical activities: climbing, bending, stooping, kneeling, twisting, reaching, sitting, standing, walking, lifting, finger dexterity, grasping, repetitive motions, talking, hearing and visual acuity. The work is performed indoors. Sits, stands, bends, lift, and moves intermittently during working hours.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The employee must be able to frequently lift up to 10 pounds and occasionally lift and/or move up to 25 pounds. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand and walk. The employee is occasionally required to use hands to finger, handle, or feel; reach with hands and arms; climb or balance and stoop, kneel, crouch, or crawl. Specific vision abilities required for this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
PERFORMANCE MEASUREMENTS
- 3-5 Monthly evaluations
- Compliance with Department Call Metrics/ Company Regulations
- Attendance/Punctuality
- Safety and Security
- Quality of work
This Job Description may be modified at any time at the discretion of the employer as business operation may seem necessary. This does not constitute an employment agreement and may not include all duties. The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. The incumbent must be able to work in a fast-paced environment with a demonstrated ability to juggle and prioritize multiple competing tasks and demands and to seek supervisory assistance as appropriate.
Solis Health Plans provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
