Medication Guide Lead & Quality Analyst

Remote /
Operations – Member Guidance /
Full-time
Our organization:
 
Our vision is to help everyone lead their healthiest lives.  And our mission is to create a significantly better medication experience for all our members, putting their health and needs first as they navigate the complexity of medications by offering our clinical expertise to them and their trusted providers to save them money and to improve their health.
 
We’re unsatisfied with the status quo in pharmacy benefits management and medication guidance.  We know that we can provide an easier and more personalized, cost-effective, and equitable experience for members, while helping our clients--those who provide pharmacy benefits--make a more impactful investment in their members’ health.
 
WithMe Health is a modern pharmacy benefits manager (PBM) with a unique personalized medication guidance solution that sits on a purpose-built technology stack and offers the best PBM member mobile app experience in the market.  Our pharmacist and pharmacy technician Medication Guides leverage this technology to bring their expertise and a human touch to proactively help our members.
 
We founded WithMe in 2018 to address the growing challenges and unmet needs with legacy PBMs: misaligned business models, frustrating interactions, unknown outcomes, high costs, and a lack of real transparency.
 
We’re growing fast.  We’ve raised $48 million from Oak HC/FT, OMERS Ventures, and other leading VCs and strategic partners to take on the $450+ billion PBM industry.
 
 

 
The role in a nutshell:
 
The Medication Guide Lead & Quality Analyst is a member of our Guide team, which is at the heart of our member experience. The Lead & Quality Analyst willprovide team oversight, perform quality review of their calls,  and monitor Guide staff metrics . This team is comprised of passionate, empathetic individuals of various skill sets who are wired for service and offer high touch support to our members 24/7/365.
 
Location:San Francisco / Bay Area, CA (and open to remote work)
Responsibilities:
 
        Help our members understand and resolve issues related to their benefits, remove barriers to accessing treatment and improve their behavior so that they better manage their health. 
        Serve as an extension of our Pharmacist team where you will collaborate with them to contact members about their treatment plan and coordinate their care. 
        Use our innovative platform to provide trustworthy information and use proven engagement and influence techniques to help our members make behavioral improvements to how they manage their health.
        Use both chat and telephonic modalities to:
        Simplify pharmacy benefits for our members and their providers by helping them understand and utilize their benefits, remove barriers to accessing treatment and offer medication guidance from a licensed clinician when appropriate
        Collaborate with our Pharmacist team to offer guidance to members when needed and to document important information about members’ health in our platform
        Drive awareness and engagement of our benefits, services and mobile App through effective and coordinated outreach to members
        Coordinate with providers and or caregivers to remove barriers and close gaps in care
        Use our engagement model to develop trusted relationships with members and improve behaviors that lead to better health decisions
        Recommend improvements to Guide center operations, training and care plans based on member or provider feedback
        Assist pharmacies with any questions/issues related to prescription claims processing
        Monitor call center metrics to ensure URAC requirements are consistently being met
        Monitor inbound and outbound calls and provide feedback for ongoing outstanding customer support
        Provide assistance to members of the Medication Guide team
        Identify opportunities to enhance the Medication Guide teams performance
        Analyze and prepare quality reports for management staff review
        Perform other duties as assigned
Qualifications and experience: 
Required:
        To succeed in this role, you need to be passionate about delivering exceptional care and service to our members.  Specifically:
        You are empathetic but understand professional boundaries and appropriate behavior
        You are wired for service and put members first through high touch support
        You are an effective communicator with exceptional oral, written and interpersonal skills
        You are a team player who is collaborative and naturally helps others
        You are eager to learn and go above and beyond your job description when required
        You are proactive and love to solve problems with creative solutions
        You are organized, detailed oriented and never forget to follow up
        You are capable of managing a large volume of phone calls, emails and chats in a timely manner
        You can effectively multitask including the ability to listen, talk and type all at once through multi-channel communications
        You are comfortable with technology and are able to navigate multiple systems to resolve issues or answer questions 
        You have strong computer skills including knowledge of all Microsoft Office applications (Powerpoint, Excel and Word)
        You are able to work a flexible schedule which will include evenings and weekends
        You have excellent team coordination and organization skills
        You are self motivated
Preferred:
        1 or more years in a medication therapy management environment as a patient care coordinator or a similar role
        1 or more years in a benefit call center setting
        Demonstrated ability to build and maintain high quality and trustworthy relationships with customers/patients via phone and electronic communication
        Proficiency with customer relationship management systems and contact center software (Preferred)
        Bilingual – Spanish (Preferred)
Education:
 
        High school degree or GED (Required)
        Bachelors or Associates (Preferred)
        Graduate of an accredited pharmacy technician training program certified by the Pharmacy Technician Certification Board or the National Health Career Association (Preferred)
 
Licensure (preferred):
        State pharmacy technician license OR
        Registered pharmacy technician
There are many reasons to come work with us, but we’ll just list a few: 
           Energetic and mission-oriented team
           Experience leadership
           Highly competitive pay
           100% employer-paid health coverage for you; 80% employer-paid health coverage for your dependents
           401(k) plan eligible day 1
           4 weeks’ PTO each year
           8 weeks’ parental leave each year for primary caregiver
           One Medical membership
           Paid life insurance
           Flex spending accounts
           Results-only work environment
 
 
WithMe Health is committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures.  If you need assistance or an accommodation due to a disability, you may contact us at legal@withmehealth.com.
 
WithMe Health’s commitment to diversity and inclusion honors and respects people from different backgrounds, experiences, and perspectives both within our workforce and for the people we serve.  By using a cooperative and compassionate mindset, our goal is to narrow the disparities in healthcare and to improve patient health for all people.