[Hiring] Clinical Programs Administration Pharmacist @Judi Health

Role Description

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:

• Triage clinical incoming calls and conduct clinical outreach calls to members, pharmacies, and prescribers.
• Support operations of clinical programs, including pharmacogenomics, MTM (Medication Therapy Management), lower cost alternative, retrospective drug utilization reviews, and other clinical initiatives as needed.
• Provide on call support as needed for after-hours pharmacist/clinical programs/emergent calls on a rotating schedule that includes nights, weekends, and holidays.
• Ensure customer satisfaction, demonstrate genuine compassion and care, optimize the customer experience, and provide professional customer support and service.
• Meet or exceed performance metrics while maintaining quality and providing superior customer service to all stakeholders.
• Effectively ask probing questions to identify and resolve multiple issues and address concerns effectively, efficiently, and in a timely manner.
• Communicate issues and resolutions to members, pharmacies, providers, and appropriate internal stakeholders.
• Remain current on all communications and updated processes relayed through multiple communication channels and apply to daily responsibilities.
• Follow all internal Standard Operating Procedures, job aids, Policies and Procedures, and adhere to HIPAA guidelines and policies.
• Follow all procedures to protect patients through safeguards for data integrity, confidentiality, and security of information as required by policies and procedures and accreditation entities.
• Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff.
• Deliver extraordinary customer care and service by responding to questions concerning customer accounts in a fast paced, structured environment within established time frame.
• Support Manager/Supervisor by assisting with additional projects as requested.
• Support staff training and development as required.
• Work collaboratively with internal business and clinical partners to support initiatives including clinical interventions, data and claims review, and on-boarding of new clients, as required.
• Maintain compliance with federal, state, local, and organizational laws, regulations, guidelines, and policies.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Qualifications

• Active, unrestricted pharmacist license.
• Bachelor's or Doctor of Pharmacy Degree with 2+ years of clinical pharmacy practice experience.
• Experience in customer service or call center experience required.
• 2+ years of prior managed care and/or clinical program administration experience and/or completion of a PGY1 Pharmacy Residency Program required.
• Excellent communication (oral and written) and organizational skills.
• Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environment.
• Self-motivated and detail-oriented problem solver.
• Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team.
• Have 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 conversations.
• Have 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 preferred.
• Medication Therapy Management (MTM) experience preferred.

Benefits

• Remote work flexibility.
• Competitive salary range: $130,000 — $135,000 USD.