- Utilizes resources to assist members in understanding components of RxCompass products including claims, accumulators, usage, balances, and cost sharing.
- Support the success of RxCompass and our clients through the development, presentation, and implementation of member-centric solutions that drive down the cost of specialty medications, while maintaining a positive member experience.
- Supports department and client requirements in the meeting of turnaround times by working as needed to ensure all referrals are handled with a focus on a timely specialty drug service solution.
- Provides support in meeting client expectations regarding efficiency, service levels, privacy maintenance, and quality of decision-making.
- Responsible for maintaining compliance with ERISA, HIPAA, and client specific requirements.
- Works as part of the team to meet business unit objectives. Expects and accepts work in an environment where change agility is fundamental to success.
- Ability to deal with a diverse customer base in a friendly manner, including medical and pharmacy office providers, hospitals, members, home infusion providers and other vendors inclusive of our drug cost saving efforts.
- Must display empathy and effective listening skills to deliver successful cost savings transitions of care.
- The ability to balance compassion, integrity, discretion, and sound judgement, with a strong desire to achieve and exceed expected metric.
- A proven background in medical/pharmacy benefits, particularly as these relate to specialty medications.
- Respect work rules and procedures.
- Acts as an advocate for change.
- Abide by all obligations under HIPAA related to Protected Health Information (PHI).
- If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources.
- Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
- Flexibility to understand, appreciate and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.
- Full-time, hourly/non-exempt position.
- Position Shift: Tuesday - Friday 11:00AM - 8:00PM CST, and Saturday 10:00AM - 6:00PM CST
- High School degree, some college preferred or equivalent experience.
- 1-2 years' experience with member engagement with PBM and Medical background.
- 1-2 years' Specialty Pharmacy or PBM experience.
- 1-2 years' CRM platform experience.
- 1-2 years' experience collaborating with Clinical, Prior Authorization, sales, account management, senior executive, and various external client facing relationships.
-
Associate Care Navigator
3 weeks ago
Southern Scripts St Louis, United StatesAssociate Care Navigator Roles and Responsibilities The Associate Care Navigator will conduct case management on behalf of the client and RxCompass ensuring specialty drug spend trend management savings in accordance with client agreement. This position will solution for lowest c ...
-
Associate Care Navigator
2 weeks ago
Southern Scripts St Louis, United StatesAssociate Care Navigator Roles and Responsibilities · The Associate Care Navigator will conduct case management on behalf of the client and RxCompass ensuring specialty drug spend trend management savings in accordance with client agreement. This position will solution for lowes ...
-
Associate Care Navigator
3 weeks ago
Southern Scripts St. Louis, MO, United StatesAssociate Care NavigatorRoles and Responsibilities · The Associate Care Navigator will conduct case management on behalf of the client and RxCompass ensuring specialty drug spend trend management savings in accordance with client agreement. This position will solution for lowest ...
-
Care Navigator
1 week ago
EmpowerMe Wellness Chesterfield, United StatesOverview · Grow your career At EmpowerMe Wellness, you'll find opportunities for promotion, continuing education, and great benefits, all while making a real difference in the life of seniors. Our results are in our success stories - come write yours with us. Join our team today ...
-
Health Care Navigator
2 weeks ago
Chestnut Health Systems Granite City, IL, United StatesOverview · The Health Care Navigator plays a pivotal role in providing essential support to veterans and their families, ensuring access to health care services and fostering self-directed recovery. This position requires a strong background in the human services field, along wit ...
-
Health Care Navigator
2 weeks ago
Chestnut Health Systems Granite City, United StatesOverview · To be considered for an interview, please make sure your application is full in line with the job specs as found below. · The Health Care Navigator plays a pivotal role in providing essential support to veterans and their families, ensuring access to health care serv ...
-
Health Care Navigator
2 weeks ago
Chestnut Health Systems Granite City, IL, United StatesThe Health Care Navigator plays a pivotal role in providing essential support to veterans and their families, ensuring access to health care services and fostering self-directed recovery. This position requires a strong background in the human services field, along with excellent ...
-
Health Care Navigator SSVF
3 weeks ago
Chestnut Health Systems Granite City, United StatesOverview: · The Health Care Navigator plays a pivotal role in providing essential support to veterans and their families, ensuring access to health care services and fostering self-directed recovery. This position requires a strong background in the human services field, along w ...
-
patient care navigator
4 weeks ago
Rush Hospital , IL, United StatesLocation: Chicago, IL · Hospital: RUSH University Medical Center · Department: Int Med General MSP · Work Type: Full Time (Total FTE between 0.9 and 1.0) · Shift: Shift 1 · Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) · Summary: · The Patient Care Navigator is responsib ...
-
NCH Healthcare System St. Louis, United States Full timeDEPARTMENT: Maternal Fetal Medicine · LOCATION: 11190 Health Park Blvd, Naples, FL, 34110 · WORK TYPE: Full Time · WORK SCHEDULE: 8 Hour Day · $10,000 Sign On Bonus · ABOUT NCH · NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthc ...
-
Physical Therapist
3 weeks ago
Amedisys St Louis, United StatesOverview · $20,000 Sign-on bonus · Full Time Days · Are you a highly skilled and compassionate physical therapist (PT) looking for a rewarding career in homecare? If so, we invite you to join our team at Amedisys, one of the largest and most trusted home health and hospice co ...
-
Registered Nurse Operating Room
4 days ago
SCA Health Saint Louis, MO, United States Full timeOverview: Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and hea ...
-
Travel Nurse
2 days ago
NationWide Therapy Group St. Louis, United StatesNationWide Therapy Group is seeking an experienced Urgent Care Registered Nurse for an exciting Travel Nursing job in Saint Louis, MO. Shift: 3x12 hr days Start Date: 07/01/2024 Duration: 13 weeks Pay: $1836 / Week About NationWide Therapy Group: · Nationwide Therapy Group is a ...
-
Financial
2 weeks ago
Kindbody St. Louis, United StatesAbout KindbodyKindbody is a leading fertility clinic network and global family-building benefits provider for employers offering the full-spectrum of reproductive care from preconception to postpartum through menopause. Kindbody is the trusted fertility benefits provider for 127 ...
-
Family Support Therapist
13 hours ago
CHADS COALITION FOR MENTAL HEALTH St. Louis, United States Part timeBenefits:Bonus Opportunities ($0 - $4000) · Maternity Leave (6 Weeks Paid) · Hybrid Work Schedule · FMLA (unpaid) · Our Impact - Saving Lives · 401(k) · 401(k) matching · Flexible schedule · Opportunity for advancement · Parental leave · Training & development · Family Support Th ...
-
Registered Nurse Endoscopy
4 days ago
SCA Health Saint Louis, MO, United States Full timeOverview: Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and hea ...
-
Registered Nurse PreOp PACU
4 days ago
SCA Health Saint Louis, MO, United States Full timeOverview: Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and hea ...
-
RN- Neuroscience
2 weeks ago
HealthEcareers - Client St. Louis, United States Full timeUp to $20,000 Sign-On Bonus for exp RNs · $10,000 for New Grad RNs · (no contract for either) · Incentives and Benefits: · Student Loan Forgiveness, up to $20,000 · Tuition Reimbursement, up to $2,000 annually for continuing educationCan access Loan Forgiveness & Tuition Reimburs ...
-
Stretcher Driver
3 weeks ago
Express Medical Transporters Manchester, United States: **Currently hiring for drivers located in the South City area · Starting at $19.00 per hour · Weekly Pay · 401(k) · Benefits including medical, dental, vision, short and long term disability options, and life insurance · Paid time off · Eliminate the commute, keep the company v ...
-
Refugee Outreach Navigator
3 days ago
Affinia Healthcare St. Louis, United StatesPOSITION SUMMARY: Perform the duties required to provide services to refugees by promoting access to preventive healthcare services, follow up care, resources to support wellbeing and healthy lifestyles through outreach, information, linkages and navigation services. · POSITION ...
Associate Care Navigator - Saint Louis, United States - Southern Scripts
Description
Job Description
Associate Care NavigatorRoles and ResponsibilitiesThe Associate Care Navigator will conduct case management on behalf of the client and RxCompass ensuring specialty drug spend trend management savings in accordance with client agreement. This position will solution for lowest cost drug while working in a high touch member centric manner, establishing a member relationship as a single point of contact. The Associate Care Navigator will provide targeted, personalized service based on a holistic view of the member, benefits, health information, and engagement. This may include site of service transitions and all other RxCompass component saving methods. This may include both medical and PBM claims. Member engagement would include telephone, written correspondence, fax, or app. Member engagements are typically non-routine and may require deviation from standard screens, scripts, and procedures to engage, consult, and educate members and providers by delivering individualized programs based upon the member's unique needs and preferences. Key areas of focus include, but not be limited to:
Supervisory Responsibility
None
Position Type and Expected Hours of WorkThis position could require overnight travel from remote location.
Required Education and ExperienceRxCompass, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, RxCompass, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
RxCompass, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of RxCompass, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/D/V
PIeb3d6aa7e