Clinical Programs Administrations Pharmacist

6 days, 5 hours ago
Full-time
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 incoming calls and conduct outreach to members, pharmacies, and prescribers.
  • Support pharmacogenomics, Medication Therapy Management, lower-cost alternative, retrospective drug utilization review, and other clinical programs.
  • Provide rotating after-hours on-call support, including nights, weekends, and holidays.
  • Resolve customer and stakeholder concerns while meeting service-quality and performance metrics.
  • Communicate issues and resolutions to members, pharmacies, providers, and internal stakeholders.
  • Review pharmacy claims and communicate findings in support of Fraud, Waste, and Abuse initiatives.
  • Collaborate on clinical interventions, claims reviews, data activities, and new-client onboarding.
  • Follow HIPAA, security, data-integrity, Standard Operating Procedure, and organizational compliance requirements.
  • Support staff training, manager-directed projects, and ongoing process updates.

Requirements

  • Active, unrestricted pharmacist license.
  • Bachelor’s or Doctor of Pharmacy degree with 2+ years of clinical pharmacy practice experience.
  • 2+ years of managed care or clinical program administration experience, or completion of a PGY1 Pharmacy Residency Program.
  • Customer service or call center experience.
  • Excellent oral and written communication and organizational skills.
  • Ability to work independently in a remote, high-volume, metric-driven call center environment.
  • Strong problem-solving, attention to detail, prioritization, and collaboration skills.
  • Secure, quiet designated workspace with a closed door during work hours.
  • Wired DSL, cable, or fiber internet connection; Wi-Fi is not permitted, and approximately 1 Gbps service is required.
  • Pharmacogenomics certification and Medication Therapy Management experience are preferred.

Benefits

  • Remote position available throughout the United States.
  • Base salary range of $130,000–$135,000 USD.
  • Rotating on-call schedule includes nights, weekends, and holidays.
  • Equal employment opportunity and nondiscrimination commitment.

Interested in this position?

Apply directly on the company website

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