Capital Rx
Clinical Care Programs Pharmacist
Capital Rx, New York, New York, us, 10261
Clinical Care Programs Pharmacist
Position Summary:Acts as a subject matter expert, providing comprehensive support for the operations of clinical programs and associated initiatives. This includes, but is not limited to,
prioritizing incoming calls, conducting outreach, effectively communicating issues and resolutions to stakeholders, and adhering to internal Standard Operating Procedures, job aids, Policies and Procedures, as well as complying with HIPAA guidelines and policies.Position Responsibilities:Triage clinical incoming calls and conduct clinical outreach calls to members, pharmacies, and prescribersSupport operations of clinical programs, including
pharmacogenomics, MTM (Medication Therapy Management), lower cost alternative, retrospective drug utilization reviews, and other clinical initiatives as neededProvide on call support as needed for after-hours pharmacist/clinical programs/emergent calls
on rotating schedule that includes nights, weekends, and holidaysEnsure customer satisfaction, demonstrate genuine compassion and care, optimize the customer experience, and provide professional customer support and serviceMeet or exceed performance metrics while maintaining quality and providing superior customer service to all stakeholdersEffectively ask probing questions to identify and resolve multiple issues and address concerns effectively, efficiently, and in a timely mannerCommunicate issues and resolutions to members, pharmacies, providers, and appropriate internal stakeholdersRemain current on all communications and updated processes relayed through multiple communication channels and apply to daily responsibilitiesFollow all internal Standard Operating Procedures, job aids, Policies and Procedures, and adhere to HIPAA guidelines and policiesFollow all procedures to protect patients through safeguards for data integrity, confidentiality, and security of information as required by policies and procedures and accreditation entitiesSupport the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staffDeliver extraordinary customer care and service by responding to questions concerning customer accounts in a fast paced, structured environment within established time frameSupport Manager/Supervisor by assisting with additional projects as requestedSupport staff training and development as requiredWork collaboratively with internal business and clinical partners to support initiatives including clinical interventions, data and claims review, and on-boarding of new clients, as requiredResponsible for adherence to the Capital Rx Code of Conduct, including reporting of noncomplianceMaintain compliance with federal, state, local, and organizational laws, regulations, guidelines, and policies
Minimum Qualifications:Active, unrestricted pharmacist licenseBachelor's or Doctor of Pharmacy Degree with 2+ years of clinical pharmacy practice experienceExperience in customer service or call center experience required2+ years of prior managed care and/or clinical program administration experience and/or completion of a PGY1 Pharmacy Residency Program requiredExcellent communication (oral and written) and organizational skillsAbility to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environmentSelf-motivated and detail-oriented problem solverAbility to handle multiple competing priorities in a dynamic environment and collaborate in a teamHave a designated workspace (an office, spare bedroom, etc.) that is visibly secure from others during work hours (closed door) and is protected from noise that could disrupt conversationsHave the following internet connectivity: DSL, cable modem or fiber with a wired connection to device (wi-fi not allowed). Internet speed of one gigabyte (940bps) is required
Preferred Qualifications:Pharmacogenomics (PGx) certification highly preferredMedication Therapy Management (MTM) experience preferred
Base Salary
:
$120,000-$125,000Nothing in this position description restricts management's right to assign or reassign duties and responsibilities to this job at any time.About Capital RxCapital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation's electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp, Capital Rx is executing its mission through the deployment of JUDI, the company's cloud-native enterprise health platform, and a Single-Ledger Model, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.Apply For This Position
Position Summary:Acts as a subject matter expert, providing comprehensive support for the operations of clinical programs and associated initiatives. This includes, but is not limited to,
prioritizing incoming calls, conducting outreach, effectively communicating issues and resolutions to stakeholders, and adhering to internal Standard Operating Procedures, job aids, Policies and Procedures, as well as complying with HIPAA guidelines and policies.Position Responsibilities:Triage clinical incoming calls and conduct clinical outreach calls to members, pharmacies, and prescribersSupport operations of clinical programs, including
pharmacogenomics, MTM (Medication Therapy Management), lower cost alternative, retrospective drug utilization reviews, and other clinical initiatives as neededProvide on call support as needed for after-hours pharmacist/clinical programs/emergent calls
on rotating schedule that includes nights, weekends, and holidaysEnsure customer satisfaction, demonstrate genuine compassion and care, optimize the customer experience, and provide professional customer support and serviceMeet or exceed performance metrics while maintaining quality and providing superior customer service to all stakeholdersEffectively ask probing questions to identify and resolve multiple issues and address concerns effectively, efficiently, and in a timely mannerCommunicate issues and resolutions to members, pharmacies, providers, and appropriate internal stakeholdersRemain current on all communications and updated processes relayed through multiple communication channels and apply to daily responsibilitiesFollow all internal Standard Operating Procedures, job aids, Policies and Procedures, and adhere to HIPAA guidelines and policiesFollow all procedures to protect patients through safeguards for data integrity, confidentiality, and security of information as required by policies and procedures and accreditation entitiesSupport the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staffDeliver extraordinary customer care and service by responding to questions concerning customer accounts in a fast paced, structured environment within established time frameSupport Manager/Supervisor by assisting with additional projects as requestedSupport staff training and development as requiredWork collaboratively with internal business and clinical partners to support initiatives including clinical interventions, data and claims review, and on-boarding of new clients, as requiredResponsible for adherence to the Capital Rx Code of Conduct, including reporting of noncomplianceMaintain compliance with federal, state, local, and organizational laws, regulations, guidelines, and policies
Minimum Qualifications:Active, unrestricted pharmacist licenseBachelor's or Doctor of Pharmacy Degree with 2+ years of clinical pharmacy practice experienceExperience in customer service or call center experience required2+ years of prior managed care and/or clinical program administration experience and/or completion of a PGY1 Pharmacy Residency Program requiredExcellent communication (oral and written) and organizational skillsAbility to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environmentSelf-motivated and detail-oriented problem solverAbility to handle multiple competing priorities in a dynamic environment and collaborate in a teamHave a designated workspace (an office, spare bedroom, etc.) that is visibly secure from others during work hours (closed door) and is protected from noise that could disrupt conversationsHave the following internet connectivity: DSL, cable modem or fiber with a wired connection to device (wi-fi not allowed). Internet speed of one gigabyte (940bps) is required
Preferred Qualifications:Pharmacogenomics (PGx) certification highly preferredMedication Therapy Management (MTM) experience preferred
Base Salary
:
$120,000-$125,000Nothing in this position description restricts management's right to assign or reassign duties and responsibilities to this job at any time.About Capital RxCapital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation's electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp, Capital Rx is executing its mission through the deployment of JUDI, the company's cloud-native enterprise health platform, and a Single-Ledger Model, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.Apply For This Position