Clinical Services Representative

Colorado Psychiatric; Oklahoma City (OK); Hybrid; USD 42,000 - 65,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Dental insurance

Employee assistance program

Health insurance

Health savings account

Life insurance

Paid time off

Tuition reimbursement

Vision insurance

Job summary

AlignRx is seeking a Clinical Services Representative to support our network pharmacies and drive clinical program participation. The role focuses on practice transformation from dispensing-only services to integrated care, and on enabling pharmacies to engage in pay-for-performance programs.

You will provide medical billing support, deliver coaching via online tools, and help pharmacies maximize revenue from platforms such as Outcomes and EQUIPP. Remote work options available.

Qualifications

• Bachelor's degree (or equivalent experience).
• Certified Pharmacy Technician (CPhT).
• Minimum of 3 years of experience in community pharmacy or healthcare-related field

Responsibilities

• Support pharmacy network through outreach and program revenue opportunities.
• Provide practice transformation coaching using AlignRx tools and resources.
• Respond to pharmacy inquiries and assist with medical billing and revenue optimization.
• Train pharmacy staff on billing platforms and identify barriers to revenue.

Skills

Customer service

Pharmacy operations

Medicare Part D

Medical billing

Communication skills

Team collaboration

Cloud tools

Excel/Office tools

Education

Bachelor's degree

Tools

Outcomes

EQUIPP

MedMonitor

Job description

AlignRx is a Public Benefit LLC (PBLLC)- a for-profit limited liability company that is intended to produce a public benefit and to operate in a sustainable manner. We are the only PSAO to establish itself as this type of legal entity, as we are deeply committed to promoting the interests of community pharmacies. You can count on us to be transparent, accountable, and passionate.

As an independently owned PSAO, we want community pharmacy owners to have maximum flexibility in their buy-side choices so they can maintain control over their business. AlignRx does not require pharmacy owners to purchase from a specific wholesaler or buying group. This benefit is just one more reason that community pharmacies experience peace of mind knowing our interests are in sync with theirs.

Our mission is to support community pharmacy by offering innovative products and services that are best in class and designed to promote the pharmacies we serve as essential healthcare providers resulting in improved patient care and outcomes.

Job Summary

The Clinical Services Representative supports the Clinical Services department’s community pharmacy support efforts to ensure AlignRx network pharmacies engage in clinical programs and improve clinical performance metrics. The position requires experience and expertise with supporting pharmacy practice transformation, moving pharmacies from just providing traditional dispensing-related services to effectively providing both dispensing and clinical services. The Clinical Services Representative plays a key role in the ongoing implementation and support of the AlignRx Performance Network.

Essential Job Functions

• Conduct outreach to pharmacies regarding payer program revenue opportunities, supporting achievement of defined completion goals.
• Compile and maintain listing of barriers identified during pharmacy outreach and present to department team members to support ongoing strategy development.
• Provide practice transformation coaching to pharmacies using online tools and resources developed by AlignRx and other industry resources, as needed.
• Provide medical billing support to pharmacies, responding to medical billing inquiries and troubleshooting issues.
• Enhance pharmacy medical billing knowledge and expertise.
• Conduct pharmacy clinical quality and performance reviews for the purpose of clinical service optimization and pay-for-performance revenue enhancement.
• Train and educate pharmacy staff on how to maximize revenue from platforms such as Outcomes, MedMonitor and EQUIPP, and other payor clinical program opportunities.
• Maintain a familiarity with public health institutions and initiatives (e.g., Community Health Workers in the pharmacy setting).
• Respond to pharmacy inquiries to the Clinical Services team in a timely manner.
• Support the monitoring of clinical program participation, performance, and revenue earned.

Additional Responsibilities

Additional responsibilities as determined by senior leadership.

Qualifications for Consideration

Required

• Education: Bachelor's degree (or equivalent experience)
• Certification: Certified Pharmacy Technician (CPhT)
• Experience: Minimum of 3 years of experience in community pharmacy or healthcare-related field

Preferred

• Experience in independent community pharmacy (e.g., working in a pharmacy, for an independent pharmacy-related organization)
• Familiarity with pharmacy platforms such as Outcomes and EQUIPP

Knowledge, Skills, and Abilities

• Strong sense of customer service
• Working experience and knowledge of pharmacy operations
• Knowledge of Medicare Part D
• Working knowledge of medical billing processes, continually developing expertise
• Knowledge of Community Health Work in pharmacy
• Strong oral and written communication skills
• Strong follow-through on projects and deliverables
• Flexible with the ability to accept change in job functions/responsibilities
• Ability to work collaboratively in a team environment including with other internal departments
• Knowledge of digital file management (e.g., SharePoint, OneDrive), use of cloud-based software including Microsoft Excel, Word, PowerPoint, Outlook, Teams

Physical Requirements/Working Conditions

• Ability to work remotely
• Maintaining remote working conditions in compliance with company policy and procedures
• Direct reports-none

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

NOTE: The above statements are intended to describe the general nature and level of work performed by an employee in this position. These statements are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees in this position.

AlignRx is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate unique differences of our employees, knowing diversity drives innovation, and the success of our business. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by applicable laws or regulations.

• Education: Bachelor's (Preferred)
• Experience: Community pharmacy or healthcare-related field: 3 years (Required)
• License/Certification: Pharmacy Technician Certification (Required)
• Work Location: Remote

Required

• Education: Bachelor's degree (or equivalent experience)
• Certification: Certified Pharmacy Technician (CPhT)
• Experience: Minimum of 3 years of experience in community pharmacy or healthcare-related field

Preferred

• Experience in independent community pharmacy (e.g., working in a pharmacy, for an independent pharmacy-related organization)
• Familiarity with pharmacy platforms such as Outcomes and EQUIPP

Knowledge, Skills, and Abilities

• Strong sense of customer service
• Working experience and knowledge of pharmacy operations
• Knowledge of Medicare Part D
• Working knowledge of medical billing processes, continually developing expertise
• Knowledge of Community Health Work in pharmacy
• Strong oral and written communication skills
• Strong follow-through on projects and deliverables
• Flexible with the ability to accept change in job functions/responsibilities
• Ability to work collaboratively in a team environment including with other internal departments
• Knowledge of digital file management (e.g., SharePoint, OneDrive), use of cloud-based software including Microsoft Excel, Word, PowerPoint, Outlook, Teams