Remote Pharmacy Benefits Advocate

AffirmedRx; Northern (KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Remote work

Job summary

AffirmedRx is seeking a Patient Care Advocate to serve as a trusted liaison between patients and healthcare providers, applying deep expertise in pharmacy benefits to ensure members receive the highest level of care and support.

The role requires sound decision-making, strong communication, and collaboration with stakeholders to resolve complex benefits questions and assist with coverage, prior authorizations, and financial assistance options.

Qualifications

• Bachelor's degree in a healthcare-related field or equivalent experience.
• 4+ years of proven experience in pharmacy benefits, managed care, or patient advocacy.
• Strong knowledge of pharmacy and medical benefit structures, prior authorization and appeals.

Responsibilities

• Serve as a liaison between patients and healthcare providers, guiding through pharmacy benefits.
• Provide guidance across prior authorization and appeals for medications.
• Assess eligibility for copay and financial assistance and connect to resources.
• Interpret PBM regulations and advise patients.

Skills

Pharmacy benefits

Prior authorization

Claims analysis

Communication skills

Interpersonal skills

Case management systems

Analytical thinking

Education

Bachelor's degree in healthcare

Tools

Claims systems

Case management software

Job description

AffirmedRx is seeking a Patient Care Advocate to serve as a trusted liaison between patients and healthcare providers, applying deep expertise in pharmacy benefits to ensure members receive the highest level of care and support.

The role requires sound decision-making, strong communication, and collaboration with stakeholders to resolve complex benefits questions and assist with coverage, prior authorizations, and financial assistance options.