Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 14 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
Work Location: Work from Home or Office for Your Day
As a Pharmacy Navigator, you will be responsible for supporting members as they navigate through their pharmacy benefits. Responsibilities include providing proactive member engagement to assist with pharmacy gaps in care, adherence concerns, costs, benefit optimization, and other initiatives. Coordinate care for those with non-optimal medication use. Collaborate with UCare departments, vendors, and other external parties to refer to additional services when needed. This role requires strong communication skills and the ability to assimilate information and data from multiple sources.
• Develop and maintain an understanding of pharmacy benefits, authorizations, the pharmacy landscape, departmental changes, and organizational initiatives to provide pharmacy-related coordination of care for UCare members.
• Work directly with members via phone, email, or other applicable means, to resolve issues, assist with concerns, and provide education and rationale for decisions. Work directly with customer services, pharmacies, providers, care coordinators, vendors, and other stakeholders to optimize care. Document interactions according to internal policies.
• Support pharmacy quality initiatives related to Star ratings, HEDIS, and population health (e.g., Assist members with medication adherence, connect members to available programs, and work with stakeholders to close gaps in care).
• Provide proactive outreach to members to notify of changes including, but not limited to, coverage determinations, formulary status changes, drug recalls, network changes, and conversion of new members to UCare formularies.
• Review internal reporting to identify members that may benefit from outreach, education, and benefit optimization.
• Respond to internal inquiries, questions, concerns, and referrals.
• Escalate clinical concerns to pharmacist staff members when necessary. Support clinical pharmacists with scheduling medication management visits and acquiring necessary documentation to support clinical work.
• Follow pharmacy department policies and procedures/work instructions to complete assigned duties.
• Other projects and duties as assigned.
BA/BS preferred; demonstrated experience may be considered in lieu of degree. Pharmacy Tech CPhT preferred.
Two years of experience in a pharmacy or health clinic setting.
Pharmacy technician experience in a clinical or managed care setting. Experience with project coordination and customer engagement. Strong knowledge of MS office products. Bilingual proficiency preferred.
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 11/9/2023