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CO
Legal Clerk I/II/III
County of Del Norte, CA
Crescent City, CA
- $19.14 to $23.29 USD / hour
…intended as a comprehensive list; it is intended to provide a representative summary of the major duties and responsibilities. Incumbent(s) may not be required to perform all duties listed,…
Added 1 min ago
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Curative HR LLC

Pharmacy Technician - Member Services

Austin, TX, United States

Apply on app.trinethire.com About employer

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Job details

Experience: Minimum 5 years experience in pharmacy or PBM operations
Posting language: English

Original job description

About Curative

Curative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*. Backed by our recent $150M in Series B funding and valuation at $1.275B, Curative is scaling rapidly and investing in AI-powered service, deeper member engagement, and a smart network designed for today’s workforce.

Our north star guides everything we do: healthcare only works when people can actually use it. That belief drives every decision we make: from how we design our plan, support our members, to how we collaborate as a team.

If you want to do meaningful work with a team that moves fast, experiments boldly, and cares deeply, Curative is the place to do it. We’re growing fast and looking for teammates who want to help transform health insurance for the better.

SUMMARY

Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around whole-person affordable preventive care featuring more benefits. Curative is looking for a Pharmacy Technician with Member Services experience who is passionate about helping the company as we work to reinvent healthcare options. Candidates will be able to utilize their previous experience in Pharmacy Operations/Member Services experience by increasing satisfaction and retention by providing Curative health plan Members, patients, and providers with accurate, consistent, timely and meaningful information. They will provide support to Members’ while building rapport and collaborative relationships with current and prospective Members in accordance with compliance guidelines. This is a remote position with multiple shift options in a 24/7 call center.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Monitoring for prescription claims rejections from 3rd party pharmacies
Outreach to members and providers with information regarding rejection and offering alternative options as applicable
Working with the Curative pharmacy prior authorization team discussing PA decisions with members and providers as needed
Evaluating extenuating requests and processing overrides as appropriate in the CAPRx JUDI system
Working with the Pharmacy team on non formulary drug alternatives for member and provider notification
Contact 3rd party pharmacies to reprocess claims, notify of drug alternatives, prior authorization status.
Correct claims and prior authorization request as needed
SME on pharmacy and drug benefits handling escalated contacts from members, providers, pharmacies, and member service team
Escalation support for after hours issues resolution as needed
Processing notifications to members services team for member outreach and status updates on prescription status
Working with leadership team on policy and process improvements
This position assumes and performs other duties, project management and data reporting as assigned
Work adhering to US regulatory and Quality System requirements (21 CFR 820, etc).

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

Excellent attendance is critical to success in this position
Internal candidates must have been in their current role for at least 6 months and have no performance or attendance actions in effect.
Excellent computer and phone skills, attention to detail, process and policy adherence
Call Center Experience preferred but not required
Excellent verbal and written communication skills.
Strong interpersonal skills.
Active listening skills to accurately respond to inquiries and requests.
Exceptional organizational skills, retention of policy and process a must
Intermediate skills minimum in google and microsoft office suite of products a must
Experience with Talkdesk (or other VOIP phone systems) preferred but not required
Experience with Helpscout (or other email ticket systems) preferred but not required
Experience with JUDI (or other prescription claims systems) preferred but not required
Experience with slack, gmail, zoom conference preferred but not required

EDUCATION and/or EXPERIENCE

Minimum 5 years experience in pharmacy or PBM operations
Associate's degree (A. A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.

CERTIFICATES, LICENSES, REGISTRATIONS

Active PTCB certification required

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Remote position
Must have a quiet place, secure, with no distractions to perform duties for work from home
Must have password protected, stable internet access - stipend will be provided
Work location MUST be secure and private to maintain HIPAA compliance for work from home
Office equipment will be supplied including: PC, monitor, keyboard, mouse, headset
While performing the duties of this Job, the employee is regularly required to sit; use hands to type, talk; and hear.
The employee is frequently required to reach with hands and arms.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
We also request, with the exception of emergencies, that you do not request any time off within the first 120 days of employment. Any request within the first 120 days if approved will be unpaid
For this position the percentage of expected Travel is:0% of the time

TRAINING EXPECTATIONS

You will attend a 2-3 week minimum remote training program.
Attendance is mandatory for the full training program
You will be required to take daily competency exams and a retention exam on the Friday of both weeks of training. Passing grades are 90% or above.
We also request, with the exception of emergencies, that you do not request any time off within the first 120 days of employment. Any request within the first 120 days if approved will be unpaid

Perks & Benefits

• Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)

• $0 copays and $0 deductibles (with completion of our Baseline Visit )

• Preventive and primary care built in

• Mental health support

• One-on-one care navigation

• Chronic condition programs (diabetes, weight, hypertension)

• Maternity and family planning support

• 24/7/365 Curative Telehealth

• Pharmacy benefits

• Comprehensive dental and vision coverage

• Employer-provided life and disability coverage with additional supplemental options

• Flexible spending accounts

• Generous PTO policy plus 11 paid annual company holidays

• 401K for employees

• Generous Up to 8–12 weeks paid parental leave, based on role eligibility.

Apply on app.trinethire.com About employer

More about this job

Skills

Pharmacy technician
Regulatory compliance
Project management
Reporting
Attention to detail
Communication skills
Interpersonal skills
Active listening
Organizational skills
Microsoft Office
Google Gmail
Office equipment

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Work requirements

Jobs in the United States