Clinical Pharmacy Operations Specialist

2 weeks ago

Orlando, Florida, United States EmpiRx Health Full time

About Us:

EmpiRx Health stands at the forefront of pharmacy benefits management, dedicated to a clinically-driven approach. As innovators in value-based pharmacy care, we prioritize our customers and their members, empowering them to manage their pharmacy benefits, healthcare outcomes, and financial results effectively.

Our Mission:

We emphasize member care above all else, focusing on health outcomes as our primary goal. Our team of pharmacists and clinicians is central to our operations, and our population health solutions provide customized strategies for our clients.

Utilizing our advanced, AI-enhanced pharmacy care platform, ClinicallyTM, our pharmacists and client management teams deliver exceptional pharmacy care, ensuring that benefits plan sponsors can maintain the health, satisfaction, and productivity of their members while significantly curtailing the rising costs of prescription drugs.

Ideal Candidate:

As we experience remarkable growth, we are in search of a proficient and experienced Clinical Operations Specialist. In this vital position, you will be responsible for mastering the adjudication platform, comprehending claim processing, and offering clinical review assistance. The Clinical Operations team must work efficiently to support clients and members, providing timely assistance for overrides and clinical reviews to guarantee a premium service experience.

If you are a driven Clinical Operations Specialist with a solid understanding of pharmacy adjudication and clinical review processes, eager to contribute positively to the healthcare sector, we welcome your interest.

Key Responsibilities:

  • Act as a primary support contact for internal EmpiRx Health teams regarding adjudication, clinical review, and claims support.
  • Ensure the prompt completion of daily tasks and assigned cases, in line with established procedures.
  • Handle escalation requests with a targeted response time of two hours.
  • Oversee claims override and prior authorization processes, providing outstanding service to clients and members.
  • Serve as a subject matter expert on the adjudication platform, showcasing a thorough understanding of claims support.
  • Work under the guidance of the Clinical Operations Manager and clinical pharmacists.
  • Communicate effectively with all EmpiRx Health departments, promoting collaboration and teamwork.

Qualifications:

  • At least five years of experience in pharmacy.
  • CPhT certification is required.
  • A minimum of two years of experience in claim adjudication.
  • At least two years of experience in prior authorization.
  • Strong commitment to customer service and delivering high-quality service.
  • Ability to thrive in a fast-paced environment.
  • Excellent time management skills to meet strict deadlines.
  • Outstanding verbal and written communication abilities.
  • Proficiency in Microsoft Office Suite.
  • A Bachelor's degree is preferred.
  • Two years of experience in a PBM, health plan, or similar environment is preferred.
  • Willingness to work in the office five days a week.

Why Join Our Team:

  • EmpiRx Health is on an exciting journey where innovation meets excellence.
  • We foster a collaborative environment that encourages innovative ideas, values open communication, and emphasizes continuous improvement.
  • Become part of a vibrant team where success is celebrated collectively, collaboration drives progress, and we work together to redefine healthcare.
  • We offer a competitive benefits package.
  • Participate in the company's success through our discretionary bonus program.

EmpiRx Health is an Equal Opportunity Employer.

We are dedicated to fostering a diverse and inclusive workplace. Discrimination and harassment of any kind based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by law are strictly prohibited.

All employment decisions are made based on business needs, job requirements, and individual qualifications. We are committed to promoting equality of opportunity for all individuals with the right mix of talent, skills, and potential. EmpiRx Health celebrates diversity and is dedicated to creating an inclusive environment for all employees.

Your future at EmpiRx Health is bright – join us in shaping the future of healthcare excellence.

  • Clinical Operations Pharmacy Specialist

    2 weeks ago

    Orlando, Florida, United States EmpiRx Health Full time

    About Us:EmpiRx Health stands at the forefront of pharmacy benefits management, driven by clinical excellence. As a trailblazer in value-oriented pharmacy care, we prioritize our customers and members, empowering them to manage their pharmacy benefits, healthcare outcomes, and financial health effectively.Our Mission:We prioritize member care above all,...

  • Clinical Pharmacy Specialist

    2 weeks ago

    Orlando, Florida, United States Walmart Full time

    Position OverviewAs a Clinical Pharmacy Specialist, you will play a crucial role in ensuring the safe and effective use of medications within our healthcare system. This is a full-time position requiring an active pharmacist license in the state of Florida.Key Responsibilities1. Prescription Verification: Conduct thorough visual checks of prescriptions to...

  • Pharmacy Operations Specialist

    1 week ago

    Orlando, Florida, United States Rose International Full time

    Position OverviewThe Pharmacy Technician plays a crucial role in assisting the pharmacist to deliver safe and effective pharmacy services to patients, adhering to the standards set by Rose International and regulatory authorities. This position operates under the direct supervision of a licensed pharmacist and is integral to the medication dispensing...

  • Pharmacy Operations Manager

    3 days ago

    Orlando, Florida, United States AdventHealth Full time

    About the RoleWe are seeking a highly skilled and experienced Pharmacy Operations Manager to join our team at AdventHealth Orlando. As a key member of our pharmacy department, you will be responsible for overseeing the daily operations of the campus pharmacy, ensuring the success of our operational, financial, and clinical functions.Key...

  • Retail Pharmacy Clinical Pharmacist

    2 weeks ago

    Orlando, Florida, United States Orlando Health Full time

    Position Overview:As a vital member of the pharmacy team, the Clinical Staff Pharmacist is responsible for executing essential pharmacist functions in alignment with scientific standards and organizational policies.This role operates on a PRN float basis, providing flexibility and support across various pharmacy settings.Key Responsibilities:Exhibit a...

  • Clinical Operations Coordinator

    1 week ago

    Orlando, Florida, United States EmpiRx Health Full time

    Job OverviewAbout EmpiRx Health:EmpiRx Health stands at the forefront of pharmacy benefits management, dedicated to a clinically-driven approach. As innovators in value-based pharmacy care, we prioritize our customers and members, empowering them to manage their pharmacy benefits, health outcomes, and financial implications effectively.Our Mission:We...

  • Pharmacy Operations Specialist

    2 weeks ago

    Orlando, Florida, United States Rose International Full time

    Position OverviewThe Pharmacy Technician plays a crucial role in assisting the pharmacist to deliver safe and effective pharmacy services to patients, adhering to the operational standards of Rose International and regulatory requirements.Key ResponsibilitiesProcess new and refill prescription orders while ensuring adherence to productivity and quality...

  • Clinical Operations Coordinator

    2 weeks ago

    Orlando, Florida, United States EmpiRx Health Full time

    Job OverviewAbout EmpiRx Health:EmpiRx Health stands at the forefront of pharmacy benefits management, driven by clinical excellence. As a leader in value-based pharmacy care, we prioritize our customers and members, empowering them to manage their pharmacy benefits, healthcare outcomes, and financial health effectively.Our Mission:We emphasize member care...

  • Clinical Operations Coordinator

    2 weeks ago

    Orlando, Florida, United States EmpiRx Health Full time

    Job OverviewAbout EmpiRx Health:EmpiRx Health stands at the forefront of pharmacy benefits management, driven by clinical excellence. As a leader in value-based pharmacy care, we prioritize our customers and members, empowering them to manage their pharmacy benefits, healthcare outcomes, and financial implications effectively.Our Mission:We emphasize member...

  • Retail Pharmacy Clinical Pharmacist

    2 weeks ago

    Orlando, Florida, United States Orlando Health Full time

    Position Overview:In this role, the Clinical Staff Pharmacist will execute essential pharmacy functions in alignment with established scientific principles and organizational policies.Role Type:This position is classified as a PRN float role.Key Responsibilities:1. Uphold safety, emergency, and risk management protocols.2. Understand and embody the mission,...

  • Clinical Pharmacist

    1 week ago

    Orlando, Florida, United States AdventHealth Central Florida Full time

    Position: Clinical Pharmacist - Patient Care SpecialistShift: Full Time Day Shift (Variable)Company Overview: AdventHealth Central Florida is a leading healthcare provider committed to delivering exceptional care to our community. Our facilities are designed to meet the needs of our patients, ensuring a holistic approach to health and wellness.GENERAL...

  • Pharmacy Support Specialist

    7 days ago

    Orlando, Florida, United States Community Health Centers Full time

    Join Our Team at Community Health CentersA career with Community Health Centers presents a unique chance to be part of a dedicated team that positively influences our community daily by enhancing individual health and overall quality of life.Why Choose Community Health Centers?Enjoy a work-life balance with no weekend shifts for most centers, along with 10...

  • Pharmacy Operations Assistant

    5 days ago

    Orlando, Florida, United States Optum Full time

    About the RoleWe are seeking a highly skilled Pharmacy Technician to join our team at Optum, a leading pharmacy care services company. As a Pharmacy Technician, you will play a critical role in supporting the functions of our mental health and specialty pharmacy, primarily through dispensing medical prescriptions and performing necessary clerical duties...

  • Pharmacy Operations Manager

    1 week ago

    Orlando, Florida, United States Care Dynamics Full time

    Comprehensive Pharmacy Staffing SolutionsCollaborate with Care Dynamics for Dependable Pharmacy StaffingAre you a pharmacy proprietor or supervisor seeking proficient individuals to enhance your workforce?Care Dynamics provides adaptable staffing solutions designed to help you sustain optimal staffing levels and ensure seamless operations.Advantages of...

  • Pharmacy Operations Technician

    1 week ago

    Orlando, Florida, United States Prime Therapeutics Full time

    Position Overview We are seeking a dedicated Pharmacy Operations Technician to join our team at Prime Therapeutics. This role is essential in ensuring the smooth operation of our pharmacy services and maintaining high standards of patient care. Key Responsibilities Work Schedule: The position operates during standard business hours, providing...

  • Pharmacy Operations Manager

    2 weeks ago

    Orlando, Florida, United States Olympia Pharmaceuticals Full time

    Job OverviewPosition Summary:Olympia Pharmaceuticals is on the lookout for a dedicated full-time Pharmacy Operations Manager to enhance our dynamic team. This key role involves supervising pharmacy functions and ensuring the accurate distribution of medications as per healthcare provider directives. Additional responsibilities encompass inventory management,...

  • Pharmacy Operations Technician

    2 weeks ago

    Orlando, Florida, United States Prime Therapeutics Full time

    Job Overview We are seeking a dedicated Pharmacy Operations Technician to join our team at Prime Therapeutics. This role is essential in ensuring the efficient processing and management of pharmaceutical orders. Key Responsibilities Work Schedule: Standard hours are Monday through Friday, from 8 AM to 7 PM. Supervision: Operate under the guidance...

  • Pharmacy Technician

    3 days ago

    Orlando, Florida, United States Actalent Full time

    Job SummaryWe are seeking a highly skilled Pharmacy Technician to join our team as a Call Center Specialist. As a Pharmacy Technician, you will play a critical role in ensuring the smooth operation of our pharmacy services.Key ResponsibilitiesManage a high volume of inbound and outbound calls, handling prescriptions from intake to fulfillment.Work across...

  • Pharmacy Operations Leader

    2 weeks ago

    Orlando, Florida, United States Devereux Advanced Behavioral Health Full time

    Join Our Team as a Pharmacy Operations LeaderAre you a seasoned pharmacist with a knack for management and a passion for patient care? At Devereux Advanced Behavioral Health, we are looking for a dedicated professional who embodies compassion and teamwork. If you thrive in a collaborative environment and are eager to work alongside leadership in a large...

  • Pharmacy Support Specialist

    2 weeks ago

    Orlando, Florida, United States US Tech Solutions, Inc. Full time

    Contract Duration: 3 monthsPosition Overview:The Pharmacy Technician plays a crucial role in assisting the pharmacist to deliver safe and effective pharmacy services to patients. This position adheres to the operational guidelines of US Tech Solutions, Inc., as well as state and federal regulations.Key Responsibilities:Support the pharmacist in managing the...