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Clinical Assistant - Fuze Care Services

Role overview

Qualifications

  • Healthcare Operations Knowledge: Familiarity with medication claims processing, pharmacy benefit management, and prior authorization workflows.
  • Clinical Support Experience: Experience researching medication discrepancies, eligibility issues, and claims-related inquiries.
  • Customer Service Orientation: Demonstrated ability to provide professional, responsive support to healthcare clients and stakeholders.
  • Technical Aptitude: Ability to learn and navigate multiple software applications, pharmacy systems, and e-prescribing platforms.

Responsibilities

  • Medication Management: Review and identify high-cost or therapeutically inappropriate medications prior to claim submission.
  • Claims & Prior Authorization Support: Maintain accurate medication profiles, eligibility information, and assisting with claims resolution.
  • Hospice Client Support: Provide high-quality support to hospice staff and serve as a trusted resource for operational inquiries.
  • Operational Workflow Management: Manage multiple work queues and maintain service-level expectations while documenting interactions thoroughly.

About the company

Alto Pharmacy logo

Alto Pharmacy

Alto is America’s leading digital pharmacy, transforming a $500 billion industry. Founded in 2015, Alto’s better pharmacy model is centered on the critical role of pharmacists as the final link in a person’s health journey. Alto combines expert pharmacist care with purpose-built technology to deliver a more convenient and affordable experience for those who need medication. To date, Alto has fulfilled more than three million prescriptions, expanded to twelve markets, and built a mobile app experience that makes it easier than ever to manage medications and chat with a pharmacist. As Alto continues its rapid growth, it remains customer obsessed, with an industry-leading NPS score of 86.

Company details

Company typeSME
Company size501 - 1000

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Job description

Job Summary
 

At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments – and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs.

Fuze Health’s foundation is built upon the strategic combination of several proven, technology-powered innovators in the digital health, diagnostics, and pharmacy sectors. Our growing portfolio brings together the capabilities of industry leaders including LetsGetChecked, Truepill, and Alto Pharmacy, to create a distinctive, unified force in healthcare. Together, we have the shared vision, advanced capabilities and talented teams to deliver next-generation solutions that patients and healthcare partners need today and into the future.



Job Description
 

The Clinical Assistant serves as a key operational and client-facing resource supporting hospice pharmacy benefit management services. This role is responsible for ensuring appropriate medication utilization, facilitating claims and prior authorization processes, supporting hospice partners, and maintaining the integrity of clinical and technical systems that enable seamless patient care.

Operating at the intersection of clinical support, pharmacy operations, and technology, the Clinical Assistant plays a critical role in reducing administrative barriers, improving medication access, and strengthening relationships with hospice providers.

Key Responsibilities:

Medication Management & Cost Stewardship:

  • Review and identify high-cost or therapeutically inappropriate medications prior to claim submission.
  • Conduct outreach to hospice partners regarding medication alternatives and formulary considerations.
  • Support efforts to reduce claim rejections, delays, and unnecessary medication-related costs.

Claims & Prior Authorization Support:

  • Maintain accurate medication profiles, eligibility information, and supporting documentation.
  • Assist with medication claims research, prior authorization requirements, and claims resolution.
  • Ensure timely processing workflows to minimize disruptions to patient care.

Hospice Client Support & Relationship Management:

  • Provide responsive, high-quality support to hospice staff regarding pharmacy benefit services.
  • Serve as a trusted resource for workflow, platform, and operational inquiries.
  • Conduct proactive follow-up to ensure issues are resolved and client needs are addressed.
  • Support relationship-building efforts through consistent communication and service excellence.

E-Prescribing Platform Support:

  • Train and support hospice staff utilizing multiple e-prescribing platforms.
  • Troubleshoot technical issues and system access concerns to prevent prescribing delays.
  • Promote effective platform utilization and user adoption across hospice partners.

Operational Workflow Management:

  • Manage multiple work queues, requests, and support activities while maintaining service-level expectations.
  • Document interactions and resolutions thoroughly to facilitate effective team collaboration and continuity of service.
  • Maintain current provider, user, and organizational profiles to prevent workflow disruptions.

System Integrity & Data Management:

  • Ensure medication records, user profiles, and system data remain accurate, complete, and up to date.
  • Maintain working knowledge of proprietary and third-party pharmacy technology platforms.
  • Identify and escalate data discrepancies, integration issues, or system concerns to appropriate stakeholders.

Cross-Functional Collaboration:

  • Act as a liaison between hospice staff, clinical pharmacists, operations teams, and technical support personnel.
  • Participate in cross-functional problem-solving and issue resolution efforts.
  • Contribute to a consistent, high-quality client support experience across all service channels.

Required Experience & Qualifications:

  • Healthcare Operations Knowledge: Familiarity with medication claims processing, pharmacy benefit management, and prior authorization workflows.
  • Clinical Support Experience: Experience researching medication discrepancies, eligibility issues, and claims-related inquiries.
  • Customer Service Orientation: Demonstrated ability to provide professional, responsive support to healthcare clients and stakeholders.
  • Technical Aptitude: Ability to learn and navigate multiple software applications, pharmacy systems, and e-prescribing platforms.
  • Communication Skills: Strong verbal and written communication skills with the ability to interact effectively across clinical, operational, and technical teams.
  • Organizational Effectiveness: Proven ability to manage multiple priorities, maintain detailed documentation, and work efficiently in a fast-paced environment.



Additional Information
 

Additional Physical Job Requirements

Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.

Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Fuze Health’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.

Salary and Benefits

Compensation Range: $19.00-$20.00/hour

Commission Eligible: No

Travel: No

Location Requirement: Fuze Health is limited to individuals residing in the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin.

Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S.

Benefits: Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&D) insurance, flexible spending account (FSA) and health savings account (HSA), commuter benefits, employer-paid short-term (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non-exempt employees) , and eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month.

More Benefits Information Here: Fuze Health Benefits Site.

Application deadline: July 15, 2026

#LI-Remote

Equal Opportunity Employer

Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com


Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.


Use of Automated Decision Tools

Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us at talent@fuzehealth.com. 


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