Time zones: EST (UTC -5), CST (UTC -6), MST (UTC -7), PST (UTC -8)
Scripta’s portfolio of products use data analytics to review pharmacy benefit transactions allowing forbetter 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, everyday. Help us change the rules of healthcare and create the future! Help us outpace other innovators inhealthcare 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 acrossScripta. 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 andcustomer service skills, an exceedingly pleasant phone manner and the ability to work as a team. Thisperson will be able to work independently and with little oversight of their day-to-day activities, whilemaintaining a high degree of professionalism. The Clinical Advocate must have the ability to criticallythink and assess members based on data (claims and eligibility) provided and feel comfortable withoutreach 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.
- 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.
- 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
To apply for this job, please email your details to businessoperations@scriptainsights.com
