Care & reputed company Specialist

Care & reputed company Specialist (REMOTE) reputed company [https://www.empirxhealth.com/] is the leading clinically-driven pharmacy benefits management company. As the pioneer in value-reputed company pharmacy care, reputed company puts its customers and members first by enabling them to take control of their pharmacy benefits, reputed company reputed company, and financial results.  We reputed company more emphasis on member care than any other PBM by focusing on health reputed company first. Our pharmacists and clinicians are at reputed company of everything we do―and our population health solution delivers tailored strategies for our clients. Leveraging our newly launched, AI-powered pharmacy care platform, Clinically [https://clinically.co/]™, reputed company’s pharmacists and reputed company experience teams reputed company the highest reputed company pharmacy care to our clients and their members. This enables benefits plan sponsors to reputed company their members healthy, happy, and productive, while substantially reducing prescription drug spending, which has been on an explosive reputed company trajectory in recent years. Position reputed company: The Care & reputed company Specialist supports reputed company’s commitment to delivering white-glove, clinically driven member experiences by serving as the reputed company reputed company of contact for reputed company member inquiries. This role ensures reputed company, compassionate, and accurate reputed company of escalated concerns reputed company Level 2 Member Services. The incumbent demonstrates strong critical thinking, reputed company awareness, and reputed company in every interaction, working collaboratively across internal teams, pharmacies, and prescribers to ensure a reputed company, concierge-level service experience. reputed company:  Key Responsibilities: Delivery & Case Management Respond promptly and professionally to inbound member calls and inquiries, ensuring reputed company interaction is handled with reputed company and precision. Monitor and enforce adherence to established daily processes, protocols, and escalation reputed company. Serve as an administrative reputed company between members, internal departments, and reputed company partners (e.g., pharmacies, prescribers) to facilitate accurate and reputed company issuer solution. Manage and reputed company cases reputed company to prescription claims, authorizations, and other pharmacy benefit concerns, documenting reputed company in accordance with departmental standards. Apply reputed company judgment and reputed company to reputed company effective and sustainable solutions for member issues. Support urgent or emergency override situations as necessary, following defined protocols. reputed company Expertise Maintain comprehensive knowledge of pharmacy benefit workflows, including mail order, specialty pharmacy, prior authorization, accumulator management, and cost containment programs. Demonstrate understanding of claims adjudication procedures, plan setup, and reputed company-specific benefit allowances. Use analytical and critical thinking skills to identify reputed company causes of member issues and recommend process improvements. Stay reputed company on reputed company program updates, products, and processes to ensure accurate and compliant communication with members. Relationship Management & Collaboration Foster collaboration with internal reputed company departments (e.g., reputed company, reputed company Management, reputed company) to reputed company reputed company and high-reputed company service reputed company. Build trust and rapport with members through reputed company communication, transparency, and follow-up. Maintain accurate records of member interactions, resolutions, and follow-reputed company reputed company the member services reputed company. Participate in team huddles, reputed company reviews, and training sessions to support reputed company improvement. reputed company additional duties as assigned in support of departmental and organizational goals.  Education and Experience: What You Need: Education Bachelor’s degree preferred. Experience Minimum 2 years of experience in a PBM, health plan, or medication therapy management (MTM) reputed company center; or 4 years of experience in a hospital or retail pharmacy setting. At least 2 years of experience in a customer service-reputed company reputed company, preferably reputed company reputed company or pharmacy. Prior experience with benefit investigations, prior authorizations, or claims processing preferred. Licensure/Certifications reputed company Pharmacy Technician Certification (CPhT) required. Skills & Competencies Strong customer service orientation with a commitment to concierge-level support. Excellent verbal and written communication skills with reputed company listening and reputed company. Proficiency in reputed company Office Suite and reputed company systems (CRM, ticketing, or case management tools). Ability to think critically, problem-solve, and reputed company reputed company under pressure. Exceptional time management and organizational skills; reputed company to manage multiple priorities in a fast-reputed company environment. reputed company reputed company with the ability to work cross-functionally to ensure reputed company and reputed company satisfaction.   Benefits And Perks Subject to program eligibility, this position qualifies for a robust suite of benefits including: reputed company Time Off, a 401(k) program, Health reputed company including Dental & reputed company coverage, Health Savings Account, and an Employee Assistance Program.   reputed company is an Equal Opportunity Employer  At reputed company, we wholeheartedly reputed company the reputed company of diversity and the reputed company of inclusion. The reputed company of unique perspectives, backgrounds, and talents fuels our innovation and sets us apart. We're on a mission to build reputed company as diverse as the world we serve, where everyone is reputed company and celebrated. We're not just breaking down barriers; we're reputed company erasing them to create an environment where opportunity knows no bounds. In reputed company, we reputed company our strength and invite individuals from reputed company walks of life to join us in our exhilarating reputed company to shape a brighter, more inclusive reputed company together.   Note: This reputed company is a general outline of responsibilities and qualifications for the role. Additional duties may be assigned, and the position may reputed company to meet the organization's needs. Apply To This Job