Customer Care Pharmacy Technician (Full-Time)

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

Capital Rx , a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,

Judi Health™ , which offers full-service health benefit management solutions to employers, TPAs, and health plans, and

Judi® , the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health .

Capital Rx has an exciting full-time opportunity for remote candidates in the continental US, with priority given to those in Hawaii.  

Location: Remote  

Shifts: Candidates must be open to working any shift.  

Position Responsibilities:  

Act as the primary point of contact for incoming member calls, prior authorization inquiries, and ensure appropriate escalation of cases and all intake notes to the Clinical Prior Authorization Team  

Actively intake a thorough and complete prior authorization request from prescribers and members by asking applicable drug and client-specific clinical questions  

Accurately advise callers on options for exception requests (formulary, copay, early refill, etc.) based on client benefit elections and provide additional information and status updates to prescribers, members, and pharmacies  

Efficiently triage incoming calls with professional phone etiquette from members, prescribers, and pharmacies with minimal support. Ask probing questions to identify and resolve all issues and address concerns promptly  

Act as a valuable resource for Customer Service Representatives supporting member and pharmacy inquiries, stepping in as needed based on demand. Proactively identify, document, and address member and pharmacy concerns to ensure everyone receives the care and attention they deserve  

Effectively communicate issues and solutions to members, pharmacies, and relevant internal stakeholders to ensure customers receive quality care and that the resolution meets all health and safety standards  

Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast-paced environment  

Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies  

Assist with onboarding and training of new team members or temporary staff as needed  

Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff  

Collaborate across different systems while utilizing up to two monitors, efficiently multitasking in a dynamic and fast-paced environment  

Self-starter who displays a positive attitude, strong work ethic, and excellent attendance  

Meet all departmental goals including schedule adherence, attendance, and quality monitoring  

Standard hours for training : Monday thru Friday, 9:00 am – 5:30 pm, Eastern  

Perform other customer support duties as assigned  

Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance  

Required Qualifications:  

High school diploma or the equivalent; associate or bachelor’s degree preferred  

A current National Certification as a Pharmacy Technician (CPhT) and a valid license are required  

2+ years of pharmacy technician experience in a clinical pharmacy setting PBM, Health Plan, or related Health Care experience required  

2+ years of customer service experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication  

Experience handling prior authorization requests/understanding of prior authorization requirements preferred  

Ability to work independently with minimal supervision, stay productive in a remote, high-volume, fast-paced, metric-driven call center environment  

Tech-savvy with proficiency in CRM systems, call center platforms, and Microsoft Office Suite.   

Demonstrated ability to meet performance metrics including call quality, resolution time, and customer satisfaction   

Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location.1 Gig plan required. Dial-up, satellite, WIFI, 5G or Cellular connections are NOT acceptable.

  Preferred Attributes   

Bilingual Spanish highly preferred  

Medicare experience preferred  

Passion for healthcare and improving patient outcomes. 

Adaptability in a startup or high-growth environment. 

Experience supporting pharmacy operations or benefits administration. 

Commitment to diversity, equity, and inclusion. 

This range represents the low and high end of the anticipated base salary range. The actual base salary will depend on several factors such as: experience, knowledge, skills, and location of the job.

Remote, US Salary Range $28 — $28 USD

All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.  

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at   https://www.judi.health/legal/privacy-policy .