Member Advocate

Member Advocate

Member Advocates work in concert with pharmacists and pharmacist technicians to provide exceptional services to our members. Member Advocates are the first point of contact to patients and serve as the voice of Tria Health. This position is extremely critical in our success and our members’ overall satisfaction. This job description should not be considered an all-inclusive listing of work requirements and may be changed at any time.

Essential Duties and Responsibilities
  • Serve as an information resource for members, clients, brokers, TPAs.
  • Answer incoming Help Desk calls for members.
  • Speak effectively on the phone to patients, physicians and clients.
  • Make appointment reminder calls.
  • Schedule appointment requests.
  • Answer questions or concerns submitted through the portal and or website.
  • Organize and file enrollment forms that are received.
  • Assist the pharmacists and/or pharmacy technicians in providing necessary data to perform their duties.
  • Develop and process required reporting and quality assurance reporting on a scheduled and “as needed” basis.
  • Process incoming and outgoing Tria mail.
  • Make outbound calls on ancillary programs that Tria Health offers.
  • Serves as primary contact for members who are calling with problems and/or questions.
  • Takes new enrollments over the phone.
  • Provide support for clinical programs, including establishing relationships with members and other health care providers.
  • Function as support and resource for clinical and sales departments.
  • Make outbound calls to engage and/or educate individuals on the Pharmacy Advocate Program.
  • Assist with printing as needed.
  • Read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
  • Other duties as assigned.
  • High school diploma or equivalent and a minimum of one-year related experience and/or training.
  • Previous customer service experience required.
  • Proficient in Email and Microsoft Office products (Word, Excel, Power Point, etc.).
Job Competencies
  • Create routine reports and correspondence.
  • Calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.
  • Ability to apply concepts of basic algebra and geometry.
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
  • Ability to deal with problems involving several concrete variables in standardized situations.
  • Perform duties at a high degree of accuracy.
  • Commitment to the Tria Health mission statement, motto and employee handbook.
Success Factors
  • Detail-orientated.
  • Pleasant phone voice.
  • Quick learner.
  • Good listening skills.
  • Ability to make connections with members.
  • Desire to help our members.
  • Team player.
  • Self-motivated.
Physical Demands and Work Environment

The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Physical Demands: While performing the duties of this job, the individual is regularly required to stand, bend, kneel, sit, walk, and use hands to finger, handle, or feel objects; reach with hands and arms; talk and hear. The vision requirements include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Individual must occasionally lift and/or move up to 15 pounds.
  • Work Environment: This job operates in a professional office environment where standard office equipment such as computer, phones, photocopiers, filing cabinets and fax machines are utilized. The noise level in the work environment is usually minimal.
  • Office Hours:Monday- Thursday 8am-9pm, Friday 10am-7pm and Saturday 9am-5pm. Member Advocates will cover those hours in a set 8-hour shift either 8am-5pm or 12pm-9pm. They also will work one Saturday a month unless business volumes or coverage needs require an additional Saturday.

*This job description should not be considered an all-inclusive listing of work requirements and may be changed at any time.

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