Administrative Support

Title: Administrative Support

Duration: 3+ Months (Possible extension)

Location: Philadelphia, PA

Responsibilities:

·Under the direction of the Manager, Clinical Outcomes & Therapeutic Optimization (COTO) the COTO Coordinator will be responsible for supporting administrative functions as well as non-clinical tasks within the COTO department for both Medicare and non-Medicare clients.

·Monitors phone queue and answer calls generated by members/providers. Forward higher complexity and/or clinical member/provider inquiries to COTO pharmacist or COTO Department Manager as appropriate.

·Provides knowledgeable and courteous member/provider customer assistance in regards to COTO Department programs and pilots.

·Acts as the primary resource for outbound call needs including but not limited to: demographic updates, refill reminder updates, scheduling of patient consultations and various member/provider outreach campaigns.

·Performs and documents general member history assessment utilizing the department’s documentation platform; records patient comments and inquiries; and review and update member demographics.

·Faxes or mails interactive consultations to members and providers which have been completed by clinical staff. Ensures tasks are completed in a timely manner.

·Reviews returned mailed, making appropriate updates, documenting information according to department policies and procedures and resolving issues when necessary.

·Proficient in use of claims processing system, JIVA and PerformPRO, including: ability to document in both systems utilizing established workflow processes, send letters to members and providers through PerformPRO, and complete items in task queue for all COTO Department programs.

·Assigns interactive consultation requests to clinical staff for member calls generated through queue. Ensures DTM task queue is up-to-date and technician tasks are completed within a timely manner.

·Follows established process workflows for inbound/outbound calls generated within department.

·Administratively supports the COTO Area. Performs varied administrative duties inclusive of handling correspondence, maintaining calendars and mailboxes,

·Reports issues with PerformPRO application to COTO Department Manager and/or Analysts.

·Forwards member inquiries outside scope of COTO to appropriate resource utilizing call tree.

·Comply with CMS & URAC MTM/DTM Standards.

·Performs other job related duties and projects as assigned.