Talent Pool: Pharmacist Assistant MMH

Momentum Centurion, Gauteng, South Africa

Complete the registration of Chronic conditions and treatments and to give support to the DUR Pharmacists.

• Matric - essential
• Pharmacist Assistant Basic - essential
• Post Basic Pharmacist Assistant Qualification or Pharmacy Technician Certificate - desirable
• Registration with the Pharmacy Council as Pharmacist Assistant - essential
• Member of the PSSA - desirable
• Minimum of 2-3 years working experience in a retail pharmacy or private hospital setting as a Post Basic Pharmacist Assistant.
• Experience in processing a prescription and dispensing medicine under the supervision of a pharmacist.
• Experience with interacting with members, pharmacists, and/or doctors in a confident and courteous manner in person and/or telephonically.
• Experience in analyzing medical history, medicines, and patients' lifestyles.
• Previous experience interacting with and counselling/guiding patients/members with regard to their medicine and diagnosis in a pharmacy setting.
• Previous chronic management and DUR experience would be an advantage.
• Previous experience in a managed care environment would be an advantage.
• Previous experience in a call centre environment would be an advantage.
• Clinical knowledge on medicine trade/ and the names and the usage of the original and generics/clones.
• Knowledge of medication classes and indications.
• Knowledge of ICD
  10 codes.
• Knowledge of The South African Pharmacy Law and good practices.
• Knowledge of physiology and basic disease conditions. Knowledge of drug indications and interactions. Knowledge of pharmacy practice, requirements of a valid prescription, valid prescriber, valid dispensing practice and record keeping.
• Understanding medical aid industry, relevant policy and clinical guidelines.
• Knowledge of diseases, management of disease lifestyle and general.
• Knowledge on how to use and navigate on a computer system.

• Manage medication benefits to ensure the most cost-effective treatment is funded for optimal treatment outcomes. Real-time provideinteraction and decision-making are essential to provide customer satisfaction whilst still keeping in line with clinical policies and scheme rules.
• Registration of treatment for chronic conditions according to guidelines and clinical entry criteria timeously and independently to ensure access to treatment.
• Authorize or decline medicine/diagnosis in line with scheme rules, mandates, and MHS clinical policies to assist in keeping the scheme financially viable whilst at the same time improving the patient's health.
• Consistently maintaining a 24-hour turnaround time from receipt of documents/calls into the correspondence workflow bin.
• Ensure effective claims management troubleshooting and support.
• Escalate any queries which cannot be handled to the DUR Pharmacists or manager for the patient or provider to get timely feedback.
• Identify all compliance risks to protocols and procedures.
• Identify and investigate all possible non-disclosure of pre-existing conditions for new members joining the scheme.
• Participates in the creation and maintenance of clinical guidelines to guide authorisation.
• Ensure the consistent and correct application of drug exclusions to prevent funding.
• Engage in effective communication and delivery according to Service Level Agreement.
• Provide professional first-time resolution on queries to ensure the best treatment outcome.
• Monitor customer delivery constraints are human or IT related and elevate these to management.
• Registration of chronic conditions is done timeously and independently if need be.
• Be involved in Oncology, maternity authorization requests, and claims reviews and escalations as part of the one-stop authorization centre going forward.
• Must handle members and providers professionally to drive Patient Advocacy with clients/members that support the business Retention and Growth targets.
• Manage the risk profile of scheme members, and decrease disease progression of the unwell.
• Perform an efficient and accurate administrative function by capturing authorization details and notes for history and disease recording.
• Identify and document compliance risks so that long‑term costs are decreased.

• To assist in improving the client experience with the team, Health Risk Management department, and Client Services.
• Provide expertise and advice to clients and internal stakeholders.
• Deliver on service level agreements made with clients and internal and external stakeholders to ensure that client expectations are managed.
• Make recommendations to improve client service and fair treatment of clients within the area of responsibility.
• Participate and contribute to a culture that builds rewarding relationships, facilitates feedback, and provides exceptional client service.
• Ensuring Patient advocacy by advising a member/provider of generics, alternatives, and DSP and assigning members to oneself to encourage lifestyle change, medicine, and treatment plan compliance.
• Must handle members and providers…