Program Support Representative I

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Role Summary

Under general supervision of the Elevate Provider Network Management Team, this associate will perform duties and tasks related to the daily operations of the Network and provide support to the managed care/pharmacy services department including primary telephone coverage, management of network database, and creation and distribution of network materials and communications.

Shift Details: Monday-Friday 8am-5pm, 2 days onsite if local to the Orange, CA office

Pay Details: $21/hr-$25/hr (DOE)

Responsibilities

• Primary telephone coverage for managed care and claims processing issues, updates to network database, creation and distribution of network materials and communications
• Provides call, fax and email support for customers, Sales Executive, Business Coach, and Managed Care Directors to resolve customer issues for all Elevate related programs.
• Troubleshoot website issues for Central Pay and Prescribe Wellness and escalates to the proper team.
• Aids with pharmacy questions and issues including accounting, reconciliation issues, funds on hold and payment inquiries.
• Calculating pharmacy reimbursements, contract, DIR and GER/BER rates.
• Serves as liaison with Elevate partnered vendors: FDS, eRx, and Prescribe Wellness.
• Awareness and understanding of Elevate Help Desk Roles, Responses, and Procedure
• Work with other team members to ensure timely and proper completion of tasks and projects as assigned by management
• Identify and report to management any process or system concerns/errors discovered through self-exploration or customer reported
• Be a strong team player. Actively participate in team and department meetings, trainings, and activities.
• Have an individual awareness of other aspects of Elevate beyond your current role and responsibilities. Understand what importance and function the other teams within Elevate have in relation to your team and functions.
• Receive and identify all MAC requests received via email and distribute accordingly. Daily entry of all requests & additions including data entry, online submission, and outcome communications. Weekly submission of research requests to PBMs.

Work Environment

• The work environment characteristics described here are representative of those an associate encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions: The noise level in the work environment is generally quiet to moderate.

Physical and Mental Requirements

• The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
• Sedentary physical activity requiring reaching, sifting, lifting, finger dexterity, grasping, feeling, repetitive motions, talking and hearing.
• Ability to lift and move up to 10 pounds.
• Visual requirement is for close vision, distance vision, peripheral vision and ability to adjust focus.
• 50% or more time is spent looking directly at a computer.
• Associate is frequently required to stand, walk (or otherwise be mobile).
• Ability to deal with stressful situations as they arise.

Education

• High School Diploma/GED or equivalent experience required.
• 2+ years of experience in customer operations, customer support, service coordination, control center operations, or a related field required.
• Certification in customer service, contact center operations, quality, or process improvement preferred.

Skills and Knowledge

• Customer service and troubleshooting skills to properly resolve common everyday issues to prevent escalations or customer complaints.
• Strong personal organizational skills to facilitate successful completion of tasks and priorities as assigned.
• Ability to work interdependently with other team members to accomplish daily tasks and processes.
• Ability to communicate effectively and professionally verbally, non-verbally, and in writing
• Possesses decision-making and problem-solving ability
• Proficient in Microsoft Office Excel (e.g., VLOOKUP, Access, Word, Power Point, and Outlook)
• Possess a high discipline for performing quality work and a strong focus on customer satisfaction
• Proficient knowledge and experience in using features of Microsoft Outlook including: E-mail File Retention and Retrieval, Contact Management, and Calendar and Task Tracking Tools.
• Preferred working knowledge or experience of pharmacy benefit management companies and retail pharmacy operations