Remote Pharmacy Benefits Advocate

AffirmedRx, a Public Benefit Corporation; Seattle (WA); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Health benefits

Remote-friendly work setup

Job summary

AffirmedRx in Seattle, WA seeks a Patient Care Advocate to navigate pharmacy benefits and support members with care decisions. You will leverage expertise in Medicare, Medicaid, and commercial plans to interpret coverage and guide patients through complex processes.

The role emphasizes independent judgment, strong communication, and collaboration with providers and pharmacies to resolve issues and improve outcomes. A private home workspace supports remote work.

Qualifications

• 4+ years of PBM, managed care, or patient advocacy experience.
• Experience with prior authorization and appeals processes.
• Ability to translate complex benefit information into clear guidance for members and providers.
• Ability to work remotely with a private, quiet workspace.

Responsibilities

• Serve as a subject matter expert on pharmacy and medical benefit structures across payer types.
• Provide guidance through prior authorization and appeals processes for prescriptions.
• Assess eligibility for copay and financial assistance; connect to resources.
• Collaborate with members, providers, and pharmacies to resolve benefit questions.

Skills

Pharmacy benefits

Prior authorization

Appeals process

Member education

Communication skills

Collaboration

Documentation

Regulatory knowledge

Remote work readiness

Education

Bachelor’s degree in healthcare

Tools

PBM software

Claims processing systems

Job description

AffirmedRx in Seattle, WA seeks a Patient Care Advocate to navigate pharmacy benefits and support members with care decisions. You will leverage expertise in Medicare, Medicaid, and commercial plans to interpret coverage and guide patients through complex processes.

The role emphasizes independent judgment, strong communication, and collaboration with providers and pharmacies to resolve issues and improve outcomes. A private home workspace supports remote work.