Shared Services Care Coordinator

Work set-up: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Experience in pharmacy operations, including claims processing and medication dispensing., Knowledge of specialty medication benefits, prior authorization, and financial assistance., Strong problem-solving skills and ability to think creatively to improve workflows., Excellent communication skills to engage with patients, providers, and care teams..

Key responsibilities:

  • Coordinate with clinic partners to manage inventory and supplies.
  • Troubleshoot prescription, claim, and payment issues, escalating when necessary.
  • Act as a liaison between patients, providers, and operational teams to resolve issues.
  • Support various areas such as PBM audits, claims reconciliation, credentialing, and project management.

Job description

Join House Rx as a Shared Services Care Coordinator, where you will play a pivotal role in enhancing access and affordability of specialty medications for patients. You’ll collaborate closely with specialty care clinics and our team to optimize the specialty pharmacy experience.

What You’ll Do:

  • Ensure our clinic partners maintain adequate inventory & supplies to meet the needs of their patients
  • Work with clinic teams to streamline processes and workflows in coordination with clinical operations team
  • Manage any issues with patient prescription attainment, including tracking packages, troubleshooting carrier issues, and monitoring work queues as assigned. 
  • Troubleshoot issues with claim processing, payment processing, equipment function (barcode scanners, label printers) and escalate to internal resources as appropriate 
  • Triage support issues related to our PMS Platform for new and existing clinic partners
  • Act as a liaison between the patient, provider and our operational team to effectively and efficiently resolve issues. Problems happen, you are responsible for delighting as you solve them. 

Additional Responsibilities:

  • Primary responsibility in at least one of the following areas and cross-training in at least one additional area:
    • PBM audits - support our clinic partners to reduce risk of payor take backs by completing payor desktop audits
    • Claims reconciliation - support our clinic partners and invoicing process through timely reconciliation of claims, identify and address missing remits and payments, and provide weekly insight to program managers
    • Credentialing - work closely with clinic partners at new and established practices to complete initial credentialing with PBMs, credentialing renewals, state regulatory agency registration (where required), and manage enrollment in EFT and ERA 
    • Legal model - work closely with sales, program managers, and clinic partners to provide an accurate summary of state specific legal requirements for MID dispensing space, provider verification registration and requirements, practice dispensing registration and requirements, and pharmacy dispensing space requirements. 
    • Accreditation - work closely with clinic partners to support initial and renewal accreditation with ACHC, URAC, and others. Support required program monitoring and auditing to maintain compliance with accreditation
    • Project management - implementation project management through leading customer calls, timely follow up, use of project management tools. Responsible for coordination with sales and program manager team to bring visibility to implementation progress and blockers. 
    • Drug ordering - support clinic partners through submission of wholesaler orders, monitor delivery, troubleshoot shortages and wholesaler catalog errors. Work closely with clinics to manage accurate inventory through training, monitoring and ongoing process improvements. Work closely with distribution leaders to manage customer-specific wholesaler account matrix to optimize customer spend. 
    • Supply management - ensure clinic partners maintain adequate inventory, optimizing supply chain efficiency while reducing costs.
    • Implementation IT workstream - work closely with implementation project manager to facilitate clinic partner IT workstream initiation, testing of EHR functionality (login, task groups, reporting, test eRx), and other IT related tasks (phone extension set up, VPN access, etc.) 

About You

  • You are someone who loves to dig in and can think outside the box
  • You are a creative problem solver interested in positively impacting each patient’s pharmacy experience
  • Self-motivated with sense of urgency for quality resolution
  • You have mastered all the core pharmacy technician skills, such as processing claims and dispensing medications, and are ready to expand your career
  • You are comfortable engaging with patients, providers, and all members of the care team both in-person and over the phone
  • You have experience navigating specialty medication benefits investigation, prior authorization, and financial assistance
  • You are excited about working in a start-up environment and enjoy solving complex problems
  • You are someone who looks for proactive solutions and can identify more efficient workflows.

Excited about the opportunity, but worried you don’t meet all the requirements? Apply anyway, and give us both the chance to find out.

 

Why You Should Join Our Team

A career at House Rx offers the chance to work with a talented group of entrepreneurs, healthcare professionals, and technology builders who are passionate about improving specialty care and making it easier for patients to access the medication that they need.

At House Rx, we strive to build and maintain an environment where employees from all backgrounds are valued, respected and have the opportunity to succeed. You'll find a culture that supports open communication, embracing failure as a learning opportunity, and always being open to new ideas—no matter how radical. We are a remote-first company, however some pharmacy operations roles require onsite clinic presence. We’re committed to creating a positive and collaborative culture to achieve our mission, all while supporting our team members in all aspects of their lives—at home, at work and everywhere in between. 

In particular, we offer:

  • Paid time off
  • Generous parental leave 
  • Comprehensive healthcare, vision and dental benefits
  • Competitive salary and equity stake

We’re backed by forward-thinking investors committed to transforming healthcare, including Bessemer Venture Partners, First Round Capital, LRV Health, Khosla Ventures, Maverick Ventures, 1984.vc, and Character.

 

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Problem Solving
  • Creative Thinking
  • Self-Motivation
  • Teamwork
  • Communication

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