Clinical Member Advocate
Posted 1 month ago
| The Clinical Advocate will work closely with our member advocates and other various teams across the company. This includes but is not limited to: Account Management, Business Operations, Marketing, Sales, and the Clinical Insights Team. This addition to the company will have top-notch communication and customer service skills, an exceedingly pleasant phone manner and the ability to work as a team. This person will be able to work independently and with little oversight of their day-to-day activities, while maintaining a high degree of professionalism. The Clinical Advocate must have the ability to critically think and assess members based on data (claims and eligibility) provided and feel comfortable with outreach to members to engage in dialogue to improve outcomes based on pharmacy utilization. |
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** Please do not use the “Apply Online” option at the bottom of the page. If you use that option, your application will not be successful since the required information will be missing.
Training or Expertise
- Experience working remotely in healthcare/insurance/pharmaceutical industry, Preferred.
- Pharmacist must have experience working in retail pharmacy, 2 years minimum
- Case Management Experience, Preferred
- Pharmacy Benefit Manager (PBM) Industry Knowledge Preferred
- Self-Funded Insurance Experience Preferred
- Experience and competency using Microsoft / Google suite of office products including Excel/Sheets, Required
- Experience in utilizing various computerized documentation tools to capture client interactions and accessing member detailed information, Required
- Member communications: Initiate and/or respond to member-initiated outreach and engagement via phone, email, or online chat.
- Provide appropriate education and answer questions about Scripta, Scripta’s applications and member’s medication utilization.
- Evaluate needs of members and clients and be able to provide cost saving medication alternatives (identified by Scripta software).
- Identify community resources as appropriate to assist in overall reduction of medication costs.
- Produce high quality documentation on an ongoing basis.
- Provide feedback to ancillary teams within Scripta as well as clients on member engagement and needs based on engagement and claims analysis.
- Carry out telephonic outreach for targeted member campaigns to increase member awareness of savings opportunities.
- Must possess both verbal and written communication skills in English and Spanish.
- Complete Special Projects as assigned.
- Maintain HIPAA compliance through daily performance.
- All other duties as assigned. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Experience
- High English level (Well spoken, well written) minimal accent Speaking.
- Ability to prioritize and organize large volumes of work.
- Self-motivated and self-starter.
- Excellent customer service skills – must be MEMBER OBSESSED!
REQUIRED SKILLS
- Bi-lingual: English and Spanish
- Communication: Excellent listening, verbal, and written communication skills
- Ability to prioritize and organize large volumes of work
- Self-motivated and self-starter
- Excellent customer service skills – must be MEMBER OBSESSED!
- Proficient in navigating internet as well as multiple operating systems and applications
- Compliance: Must understand HIPAA standards and hold privacy in the highest regard when engaging with members and clients
- Problem Solving: Identifies needs and takes independent action to implement change when and where it is needed; results driven.
Education- must meet one of the following:
- Bachelor’s Degree (Preferred) or completion of equivalent secondary level nursing and is a licensed Registered Nurse (RN) with 2 or more years of clinical experience or was a previously licensed RN with no history of revocation, voluntary surrender, fine or civil penalty, or exclusion from government payer programs within the last 5 years, and with 5 years of acute clinical experience.
- B.S. Pharm or PharmD and is currently licensed in the US.
- Licensed Practical Nurse (LPN) with 5 or more years of experience in acute clinical setting.
WAGE COMPENSATION
Compensation: : $1,600 – $1,800 USD Monthly (According the experience)
Schedule: Member Success coverage hours are 8:30 AM – 10:00 PM EST.
This is an independent contractor position requiring approximately nine scheduled hours of work per day. Hours of work are based on contract terms with some flexibility in hours to meet the needs of the clients and members. The initial engagement for this position is expected to be six months with the opportunity to continue indefinitely. Hours of work will be outlined in the offer letter.
Internet and computer must be covered by the Contractor
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