Cust Service Analyst - Specialty Pharmacy

Hamden, CT
Apr 12, 2019

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Job Description

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

EEO/AA/Disability/Veteran

Summary:
This position is responsible for customer service issues and resolution, preparation of customer service data, updating policies and training of policies, metric reporting for compliance service initiatives, attend and actively participate in compliance committee meetings, interface with legal counsel and compliance department as necessary and respond to compliance concerns. Responsible for the development, implementation and ongoing customer service monitoring to ensure all concerns, requirements, and responsibilities are addressed. Maintains current knowledge of applicable federal and state laws and regulatory agencies. Track and trend complaints and evaluate patients access to services. Create and track customer satisfaction surveys. Identify trends and implement action plans. Create a Quarterly Quality newsletter for staff education. Actively participate and report out on all Quality Improvement Projects (QIP), two per year for clients such as consumers, clients and practitioners. For the QIP need to have a baseline and establish measurable goals. One out of the two QIPs must address customer safety.

Responsibilities:
  • 1. Develop and lead customer service documentation and resolution as determined by leadership and Quality Committee.
    -Develop audit tools as necessary
    -Conduct resolution within scope of intent
    -Trend and analyze data audited
    -Prepare report and share as appropriate
  • 2. Provide support to the organization's Quality Committee. Responsible for organizing and helping to prepare monthly/quarterly meetings. Update Compliance work plan on a regular basis. Communicate to appropriate members and provide documents to communicate. Develop a plan on what Quality Improvement Programs will be initiated. Actively participate in the tracking and trending of the QIP projects. Two projects should be ongoing per year.
  • 3. Support the organization and it's departments efforts in seeking or maintaining internal/external clinical accreditation where necessary:
    - Utilization Review Accreditation Commission (URAC)
  • 4. Make recommendations to pharmacy manager and leadership for customer service findings and develop a resolution as well as corrective actions, if necessary.
  • 5. Assist in promoting and monitoring compliance to the organizational policies and procedures related to customer service and patient satisfaction. Recommend and train pharmacy staff on policies and procedures with regard to customer service and URAC standards. Assist and train new staff on customer service initiatives and quality improvement programs.
  • 6. Investigate when monitoring discrepancies or suspect audit findings suggest further review is required. Escalate as necessary.
  • 7. Work with pharmacy leadership and operations to drive compliance to policies and procedures and awareness around improving customer service as well as improving patient experience.
  • 8. Overall responsible for pharmacy customer service policies and procedure development, implementation and ensuring updated manuals. Review for completeness to ensure proper policies are established to meet legal, regulatory and compliance requirements. Ensure education and training for policy content.
  • 9. Ensures adherence to policies and procedures, legal and regulatory compliance including: Board of Pharmacy, HIPPA, DEA, IRB, FDA, NIOSH, USP, JACHO, URAC, 797/795/800, CMS and other federal and state agencies as related to clinical practice.
  • 10. Manage/oversee medication error reporting, conduct a root cause analysis as necessary. Ensure education and training on medication errors.
  • 11. Manage all customer satisfaction surveys. Track and trend all information received. Provide updates to leadership at the Quality Committee.
  • 12. Manage all customer service phone calls to patients and physicians where appropriate.

    Other information:

    EDUCATION:

    Associate degree in business or healthcare

    EXPERIENCE:

    3 years experience in healthcare/pharmacy

    LICENSURE:

    Pharmacy tech licensure required and customer service experience is preferred

    SPECIAL_SKILLS:

    Documentation skills, listening, phone skills, resolving conflict, analyzing information, multi-tasking, ability to take on projects, problem solving, detail orientation, computer skills (including Microsoft office products) and associated pharmacy software. Must have patient management expertise.
    ACCOUNTABILITY:

    The Customer Service Analyst is accountable to the Associate Director, Specialty Pharmacy for maintaining the highest professional standards. The position ensures compliance to staffing standards as documented in the Attendance and Punctuality system. The position is responsible for recommendations made to pharmacy leadership for monitoring and audit discrepancy response as well as corrective actions, if necessary.
    COMPLEXITY:

    Excellent customer service and communication skills. Must have the ability to implement and manage data bases, ability to design and implement policies and procedures. Respect the confidentiality of all information, including information regarding patients, staff members or specialty pharmacy business issues and share information to necessary parties.
    PHYSICAL_DEMAND:

    May need to travel to other pharmacy sites for internal audits. (10% travel)

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    Job Info

    Job: 7635

    Department: Hamden OPS
    Category: Admin Support
    Status: Full Time
    Shift: DAY/EVENING
    Hours: 40.00