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Clinical Programs Specialist

4 weeks, 1 day ago
United States
Full-time
Junior
Operations Specialist
Customer and Technical Support
Confluence HIPAA JIRA Salesforce Tableau
Apply Now
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
View All Jobs 48

Description

  • Triage incoming clinical program calls, schedule consultations, and conduct outreach to prescribers, pharmacies, and members.
  • Support implementation of clinical programs such as pharmacogenomics, MTM, lower-cost alternatives, opioid safety edits, and cost containment initiatives.
  • Manage and maintain drug lists, including periodic maintenance, weekly and quarterly reviews, and ad hoc updates.
  • Support reporting requirements, monitor claims, and coordinate communication among internal and external stakeholders.
  • Identify, document, and communicate issues to the appropriate internal stakeholders to support resolution and care quality.
  • Collaborate with internal business and clinical partners to support clinical program initiatives.
  • Deliver professional customer service and help ensure customer satisfaction in a fast-paced startup environment.
  • Follow internal standard operating procedures, HIPAA guidelines, and company policies.
  • Support general business needs and operational tasks as required.

Requirements

  • Active, unrestricted pharmacy technician license.
  • 2+ years of applicable experience in a clinical pharmacy setting, PBM, health plan, or related health care environment.
  • 1+ year of customer service experience with strong listening, relationship-building, and written and verbal communication skills.
  • Ability to manage multiple complex projects simultaneously with minimal direction.
  • Medication Therapy Management (MTM) experience preferred.
  • Proficiency in Microsoft Office Suite, especially Microsoft Excel and PowerPoint.
  • Experience with Confluence, Jira, Tableau, or Salesforce preferred.
  • Highly detail-oriented and analytical.
  • Bilingual Spanish preferred.

Benefits

  • Remote role with a $60,000 to $70,000 base salary range, depending on location and market tier.
  • Medical and pharmacy coverage for full-time and part-time benefit-eligible employees.
  • Dental, vision, accidental injury, critical illness, and hospital indemnity insurance options.
  • Flexible spending accounts and health savings account eligibility for full-time employees.
  • Paid time off, sick time, and paid holidays.
  • Basic life insurance, basic accidental death and dismemberment insurance, short-term disability, long-term disability, and employee assistance program at no cost to full-time employees.
  • Wellness program.
  • 401(k) plan with company match after one year of full-time employment.

Interested in this position?

Apply directly on the company website

Apply Now

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