Clinical Programs Administration Specialist (temp-to-hire)

3 weeks ago
Contract
Junior
Customer and Technical Support
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017

Description

  • Triage clinical program calls, schedule consultations, and conduct outreach to members, prescribers, and pharmacies.
  • Support clinical programs, including cost-containment initiatives and other clinical services.
  • Provide professional, compassionate support to members and providers.
  • Document outreach, case activities, interventions, and follow-up actions in applicable systems.
  • Monitor outreach queues, pending activities, and escalations to ensure timely program completion and continuity of care.
  • Identify, document, and escalate issues requiring resolution.
  • Collaborate with internal and external stakeholders to coordinate care and communication.
  • Maintain compliance with applicable regulations, HIPAA requirements, SOPs, and company policies.
  • Stay current on clinical updates, organizational communications, and process changes.

Requirements

  • Active, unrestricted pharmacy technician license.
  • At least 1 year of experience in a clinical pharmacy setting, PBM, health plan, or related healthcare environment.
  • At least 1 year of customer service experience with strong listening, relationship-building, written, and verbal communication skills.
  • A secure, closed-door workspace protected from noise during work hours.
  • Wired DSL, cable, or fiber internet connection; Wi-Fi is not permitted, and 1-gigabit speed is required.
  • Cost-containment experience preferred.
  • Proficiency with Microsoft Office, especially Excel and PowerPoint, preferred.
  • Experience with Confluence, Jira, Tableau, or Salesforce preferred.
  • Pharmacy claims experience and bilingual Spanish skills preferred.
  • Strong attention to detail and analytical ability.

Benefits

  • Remote U.S. position with a base salary range of $65,000–$70,000.
  • Six-month contract with potential extension or conversion to full-time based on business needs.

Interested in this position?

Apply directly on the company website

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