WVU Medicine is seeking a Managed Care Pharmacy Intern to support Medicare Part D quality initiatives and medication management programs. The role involves engaging with members, pharmacies, and prescribers to resolve medication-related issues and improve adherence to chronic medications.
Responsibilities
- Remain current on departmental policies, procedures, formularies, Medicare Part D requirements, MTM protocols, and all applicable regulatory standards
- Adhere to organizational procedures, including secure handling of patient information, privacy and confidentiality per HIPAA, and compliance with State Regulations and Federal Laws
- Receive inbound calls from, and deploy outbound calls to, members, pharmacies, and providers to gather information, address medication-related concerns, and determine when escalation to a pharmacist is required
- Complete calls efficiently and with high quality to meet established call center and Stars program key performance metrics
- Ensure first call resolution whenever possible to effectively address member needs, medication questions, and adherence barriers
- Engage in execution of medication therapy management (MTM), medication adherence, and other quality measure protocols, including member outreach, intervention support, and communication with pharmacies and providers
- Support pharmacists with comprehensive medication reviews (CMRs), medication adherence calls, and other quality measure outreach through pre-work, case preparation, and post-review tasks
- Assist in identifying members with medication adherence gaps and participate in targeted outreach campaigns to improve adherence to chronic medications
- Utilize clinical judgment—within intern scope—to identify potential drug therapy problems and communicate findings to supervising pharmacists
- Maintain accurate, up-to-date patient records and pharmacy system data, ensuring completeness, integrity, and compliance with CMS documentation standards
- Complete timely and thorough documentation of all outreach attempts, clinical interventions, and communication efforts
- Follow up promptly with clinics, providers, pharmacies, and members to resolve outstanding issues or medication concerns
- Participate in departmental quality improvement activities to enhance clinical outcomes, operational efficiency, and Medicare Part D Stars performance
- Support data collection and reporting efforts related to Stars measures, MTM performance, and departmental goals
- Assist with other projects and tasks as assigned to support the pharmacy team and departmental operations
- Assists managed care pharmacists with operational activities and reporting related to the pharmacy benefit manager and administration of the pharmacy benefit
- Collaborate with clinical formulary pharmacists to research and assess medication efficacy, safety, and cost-effectiveness to ensure optimal patient care while managing pharmaceutical budgets
Skills
- Must be actively enrolled in an accredited School of Pharmacy and in good academic standing as a PY2, PY3, or PY4 student
- Must possess current license or trainee license as required by state board where services will be provided: WV: Pharmacy Intern License (Registration) through West Virginia Board of Pharmacy
- Ability to handle and maintain confidential information
- Ability to work cooperatively as a team member with articulate oral and written communication and presentation skills
- Ability to work in a fast-paced and rapidly changing environment with attention to detail
- Ability to work proactively and independently to research and resolve complex issues
- Ability to apply relevant laws, regulations, requirements, and policy standards
- Extensive working knowledge of Microsoft Office applications including Excel, Outlook, PowerPoint, Teams, electronic medical records, and MTM platforms
- Must be able to communicate effectively verbally and in writing and place high emphasis on customer service
Company Overview
West Virginia University Health System is a non-profit organization that offers a full range of healthcare services. It was founded in 1898, and is headquartered in Morgantown, West Virginia, USA, with a workforce of 10001+ employees. Its website is https://wvumedicine.org/.Company H1B Sponsorship
WVU Medicine has a track record of offering H1B sponsorships, with 9 in 2025, 11 in 2024, 9 in 2023, 9 in 2022, 7 in 2021, 6 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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