Program Support Specialist PMP

Program Support Specialist PMP at TriWest Healthcare Alliance Program Support Specialist PMP at TriWest Healthcare Alliance in Fargo, North Dakota Posted in 6 days ago.

Type:

Full-Time Job Description:

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job Summary The Program Support Specialist provides operational support for the Prescription Monitoring Program (PMP), providing workflow coordination across both provider and beneficiary activities. Responsibilities include managing communication workflows, conducting outbound provider calls to verify contact information and follow up on records requests, preparing and tracking case documentation, performing EHR data entry, maintaining internal monitoring systems, and ensuring timely follow-up aligned with government reporting timelines. This position is essential to maintaining efficient program operations. Must be proficient in Microsoft Excel, Word, PowerPoint, and comfortable working within databases and electronic health record systems.

Education & Experience Required:

• High School Diploma or G.E.D.
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• 2+ years' experience in healthcare operations program support roles within healthcare, managed care or health insurance
• Proficiency in Microsoft Office applications (Excel, Word, and PowerPoint) with the ability to use Excel for structured data tracking and data organization
• Experience working within electronic health records (EHR) systems and structured internal tracking tools
• Proficient in researching provider contact information and conducting outbound calls to verify accuracy and obtain updated details
• Strong organizational and time management skills
• Ability to work independently within established program processes and timelines

Preferred:

• Associate's degree in healthcare, pharmacy, or a related field
• Knowledge of medical terminology
• Familiarity with HIPAA requirements and handling of protected health information
• Experience supporting TRICARE or other government healthcare programs Key Responsibilities
• Support end-to-end provider communication workflow, including issuance of records requests and educational materials, receipt and routing of documentation to clinical reviewers, follow-up correspondence, and tracking of all activity within internal monitoring systems.
• Monitor and reconcile incoming and outgoing communications; identify transmission issues and ensure timely resolution.
• Enter case data and review outcomes in the EHR system to ensure accurate and timely program documentation.
• Prepare and save standardized case templates for clinical review use.
• Conduct provider contact verification, including outbound calls to confirm fax, phone, and practice details.
• Support periodic government reporting and data reconciliation activities.
• Support daily workflow priorities to meet evolving government reporting deadlines and program demands.
• Support implementation of new tracking systems and workflow processes as program needs evolve.
• Handle sensitive provider and beneficiary information in accordance with HIPAA and program confidentiality standards.
• Maintain and update internal tracking databases with accurate contact information and review status updates.

Competencies Commitment to

Task:

Ability to conform to established policies and procedures; exhibit high motivation. Communication /

People Skills:

Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy:

Must be proficient in Microsoft Excel, Word, PowerPoint, and comfortable working within databases and electronic health record systems. Coping /

Flexibility:

Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. Empathy /

Customer Service:

Provides accurate, timely, and professional support across provider communications and documentation while ensuring issues are resolved efficiently and sensitive information is protected. Independent Thinking /

Self-Initiative:

Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Information Management:

Ability to manage large amounts of complex information easily, communicates clearly, and draw sound conclusions. Multi-Tasking /

Time Management:

Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills:

Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented. Problem Solving /

Analysis:

Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues. Team-Building /

Team Player:

Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills:

Proficient in data entry and Microsoft Office; ability to work in a virtual team environment.

Working Conditions Working Conditions:

• Availability to work any shift
• Ability to work overtime, if needed

Remote:

Private and secure workspace and workstation with high-speed internet is required

• Ability to work independently from home
• Extensive computer work with prolonged sitting, wearing of headset, typing, speaking on a phone
• Department of Defense security clearance required Company Overview Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®! Our job is to make sure that America's heroes get connected to health care in the community. At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996. DoD Statement Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Benefits We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes: Medical, Dental and Vision Coverage Paid time off 401(k) Retirement Savings Plan (with matching) Short-term and long-term disability, basic life, and accidental death and dismemberment insurance Tuition reimbursement Paid volunteer time TriWest job postings typically include a salary range, which can vary based on the specific role and location , but generally this position ranges from around $46,000 to $48,000 per year. Equal Employment Opportunity TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.