Case Manager, Client Paid Operations

This is a fully remote position, open to applicants in Canada.

📋 Description

• Oversee intricate prescription processing by confirming data accuracy, addressing insurance rejections, managing specialty medications, and ensuring proper documentation.

• Manage prior authorization tasks by collecting necessary documentation, submitting requests to payers, monitoring status, and following up on approvals.

• Conduct inventory tasks by tracking stock levels, processing controlled substance orders, performing cycle counts, and managing medication recalls.

• Ensure adherence to regulations, maintain essential records, prepare for audits, and comply with state board guidelines.

• Oversee specialty pharmacy operations by processing specialty pharmacy orders, collaborating with manufacturers, and ensuring appropriate storage conditions.

• Troubleshoot technical issues by resolving pharmacy system errors, researching drug-related information, addressing billing discrepancies, and escalating concerns to pharmacists.

• Execute quality assurance measures by identifying process errors, documenting incidents, and implementing corrective actions.

⛳️ Requirements

• A bachelor's degree in pharmacy, life sciences, or a related field, or equivalent experience is required.

• Minimum of 2 years of experience in pharmacy operations, retail, hospital, specialty, customer service, or a related field is required.

• Active pharmacy technician registration or licensure as mandated by the state(s) of practice is preferred.

🏝️ Benefits

• Medical, dental, and vision care.

• Backup dependent care.

• Adoption assistance.

• Infertility coverage.

• Family building support.

• Behavioral health solutions.

• Paid parental leave.

• Paid caregiver leave.

• Training programs.

• Professional development resources.

• Mentorship programs.

• Employee resource groups.

• Volunteer activities.