Job title

Clinical Services Representative

Location

Remote/Hybrid

FLSA Status

Non-Exempt

Job Summary

The Clinical Services Representative position supports the Clinical Department’s community pharmacy outreach efforts to ensure AlignRx network pharmacies engage in quality-based and clinical programs. The position focuses on positively impacting clinical program performance results.

Essential Job Functions

• Conduct regular cadence outreach to pharmacies regarding payer program revenue opportunities, supporting achievement of defined completion goals
• Compile a list of barriers identified during pharmacy outreach and present to department team members to support ongoing strategy development
• Conduct clinical quality reviews for pharmacies for the purpose of DIR mitigation, clinical service optimization, and pay-for-performance opportunities. Train and educate pharmacy staff on how to resolve MTM platform issues and refer pharmacies to platform vendors when necessary.
• Triage Clinical Connection email inquiries from pharmacies daily
• Submit help tickets to platform vendors on behalf of AlignRx network pharmacies, where applicable
• Conduct follow-up with pharmacies to ensure platform issues are successfully resolved
• Schedule and lead platform training sessions for newly onboarding staff or as a refresher for already trained staff, providing education on task list organization, Comprehensive Medication Reviews, and Targeted Medication Reviews
• Implement 1:1 calls to pharmacy staff members responsible for clinical services to provide non-clinical quality assurance feedback, ensuring accurate and successful MTM case completion specific to sig codes, physician faxes, etc.
• Create and send clinical quality reports to pharmacies, as needed
• Assist in monitoring clinical program participation rosters
• Monitor pharmacy CPESN eCare Plan submissions, ensuring eCare plan requirements are met and troubleshooting barriers, as needed
• Perform other duties and activities as determined by senior leadership

Additional Responsibilities

N/A

Minimum Qualifications for Consideration

• Education
• Associate’s or Bachelor’s degree (preferred)

• Certification
• Certified Pharmacy Technician (CPhT) (preferred)

• Experience
• Minimum of 3 years of experience in community pharmacy or healthcare-related field

Knowledge, Skills, and Abilities:

• Working experience and knowledge of pharmacy operations
• Knowledge of Medicare Part D
• Knowledge of Medicare Part B and commercial insurance medical billing
• Positive, motivated, and professional
• Strong follow-through on projects and deliverables
• Flexible with ability to accept change in job functions/responsibilities
• Proficient in speaking to pharmacy staff, health plans, and PBMs
• Ability to work collaboratively in a team environment including with other internal departments
• Computer skills to include file management, Internet, Microsoft Windows, word processing, spreadsheets, presentation software
• Database management

Physical Requirements/Working Conditions

• Ability to work remotely
• Maintaining of remote working conditions in compliance with company policy and procedures
• When onsite at corporate office, professional office environment
• Traveling to client locations, corporate office, other sites, and industry conferences, as needed

Direct reports

N/A

NOTE: The above statements are intended to describe the general nature and level of work performed by an employee in this position. These statements are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees in this position.

AlignRx is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status, creed, status with respect to public assistance, genetic status or any other status protected by federal , state or local law.

Job Type: Full-time

Pay: From $18.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance
• Work from home

Schedule:

• Monday to Friday

COVID-19 considerations:
The company follows CDC guidelines regarding COVID-19.

Education:

• Associate (Preferred)

Experience:

• pharmacy or healthcare: 3 years (Required)

License/Certification:

• PTCB or NHA Certification (Preferred)

Work Location: Remote

Please Note :
epokagency.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, epokagency.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.