Headquarters: Wellesley, MA
URL: https://scriptainsights.com
Scripta’s portfolio of products use data analytics to review pharmacy benefit transactions allowing for better decision making both at the corporate level and at the employee level. The result is that self-insured employers, and employees save money on their pharmacy benefits every transaction, every day. Help us change the rules of healthcare and create the future! Help us outpace other innovators in healthcare to deliver better care to patients, decrease cost and improve population health.
The Clinical Advocate will work closely with our member advocates and other various teams across Scripta. This includes but is not limited to: Account Management, Business Operations, Marketing, Sales, and the Clinical Insights Team. This addition to Scripta will have top-notch communication and customer service skills, an exceedingly pleasant phone manner and the ability to work as a team. This person will be able to work independently and with little oversight of their day-to-day activities, while maintaining a high degree of professionalism. The Clinical Advocate must have the ability to critically think and assess members based on data (claims and eligibility) provided and feel comfortable with outreach to members to engage in dialogue to improve outcomes based on pharmacy utilization.
Essential Duties and Primary Responsibilities:
Member communications: Initiate and/or respond to member-initiated outreach and engagement via phone, email, or online chat.
Provide appropriate education and answer questions about Scripta, Scripta’s applications and member’s medication utilization
Evaluate needs of members and clients and be able to provide cost saving medication alternatives (identified by Scripta software).
Identify community resources as appropriate to assist in overall reduction of medication costs
Produce high quality documentation on an ongoing basis
Answer incoming phone calls and live chats with Member Success team – to be a shared responsibility with the Member Advocates
Provide feedback to ancillary teams within Scripta as well as clients on member engagement and needs based on engagement and claims analysis
Carry out telephonic outreach for targeted member campaigns to increase member awareness of savings opportunities.
This role will serve as point of escalation and shift lead, after standard business hours or when the Manager of Member Success is unavailable.
Must possess both verbal and written communication skills in English and Spanish.
Complete Special Projects as assigned
Maintain HIPAA compliance through daily performance
All other duties as assigned. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Requirements
Availability: 1pm – 10pm Eastern Time
Bi-lingual: English and Spanish unless exempt when hired.
Communication: Excellent listening, verbal, and written communication skills
Ability to prioritize and organize large volumes of work
Self-motivated and self-starter
Excellent customer service skills – must be MEMBER OBSESSED!
Proficient in navigating internet as well as multiple operating systems and applications
Compliance: Must understand HIPAA standards and hold privacy in the highest regard when engaging with members and clients
Problem Solving: Identifies needs and takes independent action to implement change when and where it is needed; results driven.
Education- must meet one of the following:
Bachelor’s Degree (Preferred) or completion of equivalent secondary level nursing education and is a licensed Registered Nurse (RN) with 2 or more years of clinical experience or was a previously licensed RN with no history of revocation, voluntary surrender, fine or civil penalty, or exclusion from government payer programs within the last 5 years, and with 5 years of acute clinical experience.
B.S. Pharm or PharmD and is currently licensed in the US.
Licensed Practical Nurse (LPN) with 5 or more years of experience in acute clinical or physician practice setting.
Experience working remotely in healthcare/insurance/pharmaceutical industry, Preferred.
Pharmacist must have experience working in retail pharmacy, 2 years minimum
Case Management Experience, Preferred
Pharmacy Benefit Manager (PBM) Industry Knowledge Preferred
Self-Funded Insurance Experience Preferred
Experience and competency using Microsoft / Google suite of office products including Excel/Sheets, Required
Experience in utilizing various computerized documentation tools to capture client interactions and accessing member detailed information, Required
Disclaimer: Diversity creates a healthier atmosphere: Scripta Insights is an Equal Employment Opportunity/Affirmative Action Employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status,
disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Independent contractors have no specified contract term and can be terminated at will.
To apply: https://weworkremotely.com/remote-jobs/scripta-insights-clinical-advocate
