Amerihealth Caritas

Role Description As a Community Health Choices (CHC) Provider Network Account Executive, you will play a vital role in building and nurturing connections with healthcare providers. - Serve as the primary liaison between the Plan and assigned providers, ensuring a thorough understanding of contract terms, provider needs, and performance expectations. - Conduct tailored provider onboarding and educational sessions; resolve issues to support provider engagement and satisfaction. - Monitor network adequacy and ensure compliance with state and federal access standards across all product lines. - Identify and recruit qualified providers in new and existing service areas, ensuring alignment with financial and contractual requirements. - Analyze provider performance using Plan reports and metrics; develop and implement improvement strategies based on data insights. - Support corrective action processes, including provider terminations, in accordance with Plan policies. - Collaborate with the Quality Management team on credentialing, re-credentialing, member complaints, and quality-of-care investigations. - Maintain accurate provider data in Facets and coordinate updates with the Provider Maintenance Department. - Prepare and submit timely reports on activities, metrics, and outcomes. - Build and sustain effective partnerships with internal departments and stakeholders. Work Arrangement: - Associates can work remotely. - Must live in CST or EST time zone. Preferably candidates in or around PA. - Possible travel to Annual Conferences. Qualifications - Bachelor’s degree or equivalent experience preferred. - High school diploma/GED required. - 1–3 years of experience in a Provider Services role working directly with providers. - 3–5 years of experience in the managed care or health insurance industry. - Experience with Medicare, Medicaid, or ACA Exchange preferred. Requirements - Ability to establish and maintain trust-based partnerships with healthcare providers and internal teams. - Strong problem-solving skills to manage and de-escalate provider concerns with professionalism and diplomacy. - Self-starter with excellent time management skills and the ability to work independently. - Skilled at balancing competing demands across provider accounts, projects, and deadlines. - Effective collaboration with cross-functional teams within internal departments. Benefits - Flexible work solutions, including remote options and hybrid schedules. - Competitive pay. - Paid time off (including holidays and volunteer events). - Health insurance coverage for you and your dependents starting Day 1. - 401(k). - Tuition reimbursement. - And more.

Role Description The Community Health Educator, Senior supports the development and execution of outreach strategies within an assigned territory to improve health outcomes, reduce healthcare costs, and increase member engagement. This role delivers health education, supports community-based programming, assists with Social Determinants of Health (SDOH) surveys, and documents outreach activities and outcomes in Jiva. The position operates in both field-based and wellness center settings (brick-and-mortar and mobile) and serves as a senior-level resource for community education initiatives. Work Arrangements - Remote - The associate can work remotely from anywhere in Northern Michigan (MI) and will primarily serve Region 2 or Region 3 Michigan Medicaid service territories. - Region 2 counties: Emmet, Charlevoix, Antrim, Kalkaska, Leelanau, Grand Traverse, Benzie, Manistee, Wexford, and Missaukee. - Region 3 counties: Cheboygan, Presque Isle, Otsego, Montmorency, Alpena, Crawford, Oscoda, Alcona, Roscommon, Ogemaw, and Iosco. - Region 5 counties: Clare, Gladwin, Arenac, Isabella, Midland, Bay, Gratiot, and Saginaw (as needed only). - Ability to travel extensively within assigned communities required. Responsibilities - Execute outreach strategies within the assigned territory by participating in community events, conducting member outreach, and delivering health education and resources. - Assist with completing SDOH surveys and ensure accurate documentation of outcomes in Jiva. - Support one or more functional focus areas based on territory needs, including Community Programs and Events, Community Education, and Member Outreach. - Work in the field and in wellness center environments (brick-and-mortar and mobile) to support member events, educational programming, and related initiatives. - Develop new health education programs and implement, maintain, and enhance existing programs to meet members and community needs. - Collaborate with providers and community partners to coordinate and support health screenings and educational events for members. - Mentor, coach, and provide guidance to Community Health Educators, as assigned by the supervisor. - Accurately track, document, and report outreach activities and outcomes in accordance with departmental guidelines. - Perform additional duties and assigned special projects as directed by the supervisor. Qualifications - Bachelor’s Degree required. - 3 to 5 years of experience in health education, public health, community outreach, or marketing required. - Additional licenses or certifications as required by state regulations. Licensure - Valid driver’s license and access to an adequately insured vehicle in accordance with state requirements are required. Skills & Abilities - Strong knowledge of public and health education principles, community outreach strategies, and population health concepts. - Understanding of the healthcare industry and managed care environment preferred. - Ability to engage diverse populations and deliver education in community-based and clinical settings. - Strong communication and interpersonal skills, with the ability to build relationships with members, providers, and community partners. - Organizational skills with the ability to manage multiple activities, events, and priorities. - Experience mentoring or supporting peers in a team-based environment. - Proficiency with documentation systems and tools; experience with care management or outreach platforms preferred. - Ability to lift up to 25 pounds.

Role Description The Payment Integrity Analyst is responsible for conducting research and analysis and reviewing regulatory edits for federal and state statutes, regulations, provider manuals, bulletins, and other sources as needed to identify new overpayment edit concepts, as well as, validate all prospective and retrospective overpayment results. Essential Functions: - Identifies, develops, and implements new concepts that will target claim overpayment scenarios for each of ACFC’s Medicaid and Medicare lines of business. - Assists with ensuring that the current prospective and retrospective cost avoidance/overpayment recovery processes are carried out within the established deadlines with a high level of accuracy. - Performs analysis on claims data, comparison reports, and State regulations for each state-specific edit on payer or state specific requirements. - Communicates effectively with each of our customers throughout the organization. - Reviews edit concept results for quality assurance and proof of concept validation. - Reviews all available sources including federal and state statutes, regulations, provider manuals, Provider contracts, and bulletins for changes to and/or new payment rules. - Identifies and documents changes to and/or new payment rules or language in the source document which may be utilized to update existing system edits or new system edits. - Contributes new ideas for improving existing processes. - Understands and applies all established SOPs for each of the teams processes. - Adheres to line of business specific procedures to perform routine functions based on department guidelines. Qualifications - 3 to 5 years relevant experience (healthcare claim reimbursement methodologies, state and federal payment policies, claims, data analysis). - Bachelor's Degree or equivalent work experience. - Active CPC. Requirements - Access to a reliable high-speed internet connection for remote or hybrid roles (minimum bandwidth of 50 Mbps download and 5 Mbps upload). - Ability to submit for reimbursement if residing in states where service is required by contract, law, or regulation. Benefits - Flexible work solutions including remote options and hybrid work schedules. - Competitive pay. - Paid time off including holidays and volunteer events. - Health insurance coverage for you and your dependents on Day 1. - 401(k). - Tuition reimbursement and more.

Role Description The Innovation Manager supports the development and execution of high-impact innovation initiatives focused on advancing care and support for complex populations—such as dually eligible members, multi-system youth, and individuals seeking economic self-sufficiency. This role is integral to designing and managing differentiated products, coordinating across systems and stakeholders, and contributing to innovation projects that support enterprise growth, program performance, and improved health outcomes. The Innovation Manager helps translate vision into action—supporting demonstration design, managing external partnerships, coordinating across internal teams (clinical, IT, operations, strategy), and ensuring effective execution of key pilots and transformation initiatives. Work Arrangement: This is a 100% Remote Position Responsibilities - Innovation Project & Program Management - Support the development, implementation, and monitoring of innovation initiatives and pilots across priority areas including: - Economic mobility and employment support - Multi-system youth programs integrating behavioral health, education, and child welfare - Integrated care models for duals and high-need populations - Develop and manage project plans, timelines, and documentation to ensure timely execution and visibility across leadership and partners. - Coordinate across departments (e.g., clinical, product, analytics, IT, operations) to ensure alignment and resolve barriers. - Stakeholder Engagement & Partnership Coordination - Help manage relationships with external innovation partners, including vendors, community organizations, and demonstration collaborators. - Support due diligence, onboarding, and contract oversight for partners contributing to pilots or integrated solutions. - Assist in facilitating co-design sessions, steering committees, and stakeholder workshops to gather input and drive shared ownership. - Develop strong communications strategy for clients, stakeholders, and state leadership. - Solution Design & Policy Alignment - Conduct research and environmental scans to inform the development of innovative solutions aligned with member needs, state priorities, and industry best practices. - Assist in translating state policy requirements (e.g., waiver language, RFP scopes) into solution features and operational models. - Support development of solution documentation such as use cases, program models, value propositions, and implementation plans. - Measurement, Learning & Best Practices - Coordinate with analytics and evaluation teams to monitor KPIs, capture learnings, and support continuous improvement of innovation efforts. - Maintain awareness of industry-leading models, competitor activity, and emerging practices relevant to managed care innovation. - Help develop briefing materials, case studies, and internal reports to inform leadership and support scaling decisions. Qualifications - Master’s Degree: MPH, MBA, MPP, MHA strongly preferred. - Preferred Experience Level: Fulsome understanding of health and human service issues such as eligibility, food insecurity, physical and nutritional health, behavioral health, and evidence-based practices to best meet the needs of high acuity populations. - At least eight to ten (8 to 10) years of experience in healthcare innovation, public program design, strategy, project management, or a related field. Requirements - Working knowledge of Medicaid, Medicare, or duals programs, and familiarity with public sector healthcare delivery systems, as well as other safety net functions like juvenile justice or child welfare and behavioral health. - Experience supporting or managing complex, cross-functional initiatives involving diverse internal and external stakeholders. - Strong organizational and communication skills, with attention to detail and an ability to manage multiple priorities. - Proficient in tools such as Excel, PowerPoint, project management software. - Team members must work across the growth team and closely collaborate across other key partners, including markets, public affairs, IT, finance, and clinical teams. - The candidate must be a skilled collaborator, communicator, problem solver, detail-oriented, and highly organized. Benefits - Flexible work solutions including remote options, hybrid work schedules. - Competitive pay. - Paid time off including holidays and volunteer events. - Health insurance coverage for you and your dependents on Day 1. - 401(k). - Tuition reimbursement and more.

Role Description The Manager, Medical Economics & Business Process leads a team responsible for delivering healthcare data and medical economics analyses across a variety of data sources, including claims, authorizations, member, and provider data. This role partners closely with cross-functional teams to structure and execute analyses, generate insights, and identify opportunities to improve medical costs, operational performance, and overall business outcomes. This is a hands-on role, which combines team leadership with active analytic contributions to core workstreams. Work Arrangement: Remote - This position is fully remote and may be performed from any location within the United States; however, the associate is required to work during Eastern Standard Time (EST) hours. Responsibilities - Lead complex analyses addressing healthcare cost, utilization, and operational performance using internal and external data sources. - Demonstrate a comprehensive understanding of key drivers of healthcare trends and effectively synthesize complex concepts for diverse audiences. - Serve as a trusted advisor to business partners by translating medical costs and operational insights into strategic opportunities and recommendations. - Mentor, develop, and lead a high-performing analytics team focused on market-level and enterprise healthcare financial and operational data. - Collaborate and build strong relationships with cross-functional partners to understand business questions and deliver actionable insights. - Translate business needs into clear analytic requests and guide the development of appropriate methodologies. - Design and develop innovative analytic solutions, tools, and approaches to address complex business problems. - Work comfortably with large, complex, and diverse healthcare data sets to support decision-making and performance improvement. Qualifications - Bachelor’s degree in actuarial science, economics, computer science, or a related field required. - Master’s degree is preferred. - 5 to 10 years of health plan analytics with in-depth analytics, technical expertise, and business knowledge. - 5 years of experience presenting analytical results. - 5 years of experience in healthcare data analysis and information reporting. - 5 years of experience with SQL, Tableau, and PowerBI. - Facilitation, decision-making, organizational/business expertise, and analytical skills. - Leadership, supervisory, or team-leader experience. Skills & Abilities - Strong understanding of Medicaid managed care, healthcare, and operational data. - Advanced analytical and problem-solving skills with the ability to address complex business questions. - Advanced capabilities in pulling, validating, and synthesizing data to derive actionable insights for the organization. - Excellent verbal and written communication skills, with the ability to clearly convey insights to technical and non-technical audiences. - Proven leadership and mentoring skills, with experience developing high-performing analytic teams. - Strong organizational skills and ability to manage multiple priorities in a fast-paced environment. - Ability to think strategically while maintaining attention to detail and data accuracy.

Role Description This position is responsible for participating in the day-to-day activities of the AmeriHealth Caritas North Carolina Provider Network Operations department and supervises, directs, monitors, reviews, and coaches staff and their work performance. - Responsible for assisting the Manager with the implementation of new departmental initiatives and process changes. - Assists with the implementation of process changes to ensure department efficiency and compliance with contractual and internal requirements and Service Level Agreements. - Researches and supervises the research of informal provider inquiries and complaints to be sure all are resolved in a timely manner to ensure minimal disruption of the Plan’s network and provides management with issue feedback. - Oversees and monitors provider data maintenance and/or claims activities and provides feedback and recommendations. - Monitors operational compliance with Plan policies and procedures and recommends solutions to management when problems occur. Work Arrangement - Remote role - Monday through Friday, 8:30 AM EST to 5:00 PM EST Qualifications - Associate Degree or equivalent combination of education and work experience required. - Business experience in managed care or related healthcare setting to include claims coding/payment and/or provider data preferred. - Minimum of 1 year of supervisory/management/leadership experience preferred. - Knowledge of Medicaid reimbursement and methodologies preferred. - Knowledge of provider data maintenance. Skills - This is not an IT/IS Network position. We need a Provider Relations Operations Supervisor that knows managed care and has Medicaid Claims experience. Benefits - Flexible work solutions including remote options, hybrid work schedules. - Competitive pay. - Paid time off including holidays and volunteer events. - Health insurance coverage for you and your dependents on Day 1. - 401(k). - Tuition reimbursement and more.

Role Description Reporting to the Director, Proposal Strategy and Management, the Medicaid Proposal Management Director provides strategic and operational leadership for complex Medicaid proposal efforts across the enterprise. This role serves as the senior pursuit lead for priority opportunities, translating capture strategy into disciplined, end-to-end proposal execution that consistently produces high-scoring, compliant, and compelling responses. The Medicaid Proposal Management Director leads and mentors Proposal Operations Managers and matrixed teams, ensuring alignment among capture, solution design, proposal writing, production, and implementation hand-off. This highly visible role frequently interfaces with executive leadership, health plan CEOs, and functional leaders to resolve issues, secure decisions, and align on strategy, commitments, and risk posture. This is a 100% remote position but we prefer you live in EST or CST time zones. Responsibilities - Serve as overall proposal lead for assigned, high-priority Medicaid RFXs from opportunity kickoff through submission, orals/interviews, BAFOs, and post-award debriefs and hand-offs. - Oversee development and maintenance of a comprehensive proposal execution blueprint for each pursuit, including proposal calendar, response matrix, decision log, and risk issue plans. - Ensure each pursuit is executed in alignment with enterprise capture strategy, market positioning, and win themes, and that proposal direction is continuously refined based on RFX amendments, Q&A, and competitive intelligence. - Oversee the RFX Q&A and amendment process, ensuring material changes are rapidly analyzed, risks are clearly communicated, and updates to solution, narrative, pricing inputs, and implementation plans are coordinated. - Ensure meticulous review and interpretation of solicitations, including submission instructions, formats, page limits, portal/physical submission requirements, mandatory forms, and evaluation/scoring criteria. - Enforce a disciplined compliance and quality framework, including compliance matrices and traceability mapping, structured quality reviews (e.g., Shipley-style color reviews) with clear entry/exit criteria, and standards for version control, naming conventions, document structure, and graphics. - Own risk and issue management at the pursuit level, ensuring timely escalation to leadership with clear options, trade-offs, and recommendations. - Ensure internal consistency of commitments and data across volumes, forms, and appendices, and that proposal promises and operational commitments are captured and transferred to business owners in a timely, traceable manner. - Lead post-award debriefs and lessons-learned sessions for assigned pursuits; synthesize feedback into clear, actionable improvements to processes, tools, and templates. - Partner with Proposal Operations Managers and Proposal Enablement/Knowledge Management resources to refine standard templates, checklists, and execution playbooks; enhance content libraries and reusable components guided by win/loss insights; embed AI, analytics, and collaboration tools to improve efficiency, quality, and visibility; and contribute to the evolution of a standardized, repeatable proposal operating model, aligned with Shipley best practices, and tailored to Medicaid managed care. - Adapt work hours and patterns to support critical RFX milestones, including evenings and weekends when necessary to meet non-negotiable deadlines. - Model healthy workload management where possible (early planning, realistic commitments, clear escalation paths) while acknowledging and managing the inherent demands of the role. - Maintain composure, sound judgment, and a solutions-oriented mindset under high workload, tight timelines, shifting priorities, and ambiguity. - Model and promote best-practice proposal management disciplines, including Shipley-style methods, structured reviews, and disciplined document control. - Lead efficient, action-oriented status and decision-making forums (often daily or more frequently at peak) that focus leaders and contributors on decisions, risks, and next actions. - Serve as a primary point of contact for executives and senior leaders for assigned pursuits, presenting status, risks, options, and recommendations concisely and credibly. - Ensure tight alignment across Enterprise Growth, market leadership, clinical and operational partners, and control functions (e.g., compliance, legal, finance, IT, network, quality). Qualifications - Bachelor’s Degree in Business, Communications, English, Healthcare Administration, Public Policy, or a related field; or an equivalent combination of education and directly relevant experience. - At least seven (7) or more years of progressive experience in proposal management, capture management, or complex project/program management in healthcare, including direct responsibility for Medicaid or other government-sponsored managed care RFXs and demonstrated ownership of end-to-end proposal success (schedule, quality, compliance, and win outcomes). Requirements - Experience leading large, multi-volume Medicaid RFPs and managing multiple, concurrent RFXs of varying size and complexity. - Demonstrated experience coaching and guiding proposal professionals (e.g., Proposal Operations Managers, proposal coordinators, writers) and leading cross-functional teams in a matrixed environment. - Outstanding written and verbal communication skills, including the ability to distill complex Medicaid and technical content into clear, simple, and persuasive language for executive, clinical, operational, technical, and regulatory audiences. - Proven attention to detail and document control discipline, including structure, formatting, and document organization, grammar, punctuation, and style consistency, and cross-references, citations, and data integrity across multiple volumes and attachments. - Strong, practical understanding of Medicaid managed care products and programs, procurement processes, and scoring methodologies. - Advanced proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) and collaboration/project management tools (e.g., SharePoint, project trackers, virtual whiteboards). Benefits - Flexible work solutions including remote options, hybrid work schedules. - Competitive pay. - Paid time off including holidays and volunteer events. - Health insurance coverage for you and your dependents on Day 1. - 401(k). - Tuition reimbursement and more. Company Description At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

Role Description As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long-term services and support they need as required by the Community Health Choices (CHC) agreement. You will contribute to the care coordination process by performing face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support, as well as telephonic follow-up. Work Arrangement: - Remote - Must be able to travel up to 90 minutes from your home to Chester, Bucks, Montgomery, Delaware, and Philadelphia Pennsylvania counties Responsibilities - Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports - Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation - Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options - Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process - Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP - Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements - Works with the participant to complete activities necessary to maintain eligibility Qualifications - Bachelor’s Degree in social work, psychology, or related field is preferred - 3+ years of social service (in lieu of a Bachelor’s degree) or related healthcare experience that required: - working with people who need personal care services - conducting face-to-face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services - knowledge of the home and community-based service system and how to access/arrange for services - maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests - 2 to 3 years of Case management experience Requirements - Valid and current driver’s license Skills & Abilities - Must be computer proficient and have a working knowledge of MS Office specifically Excel - High speed internet - Dedicated home workspace free from distractions and conducive to HIPAA and Government compliance regulations Benefits - Flexible work solutions, including remote options and hybrid work schedules - Competitive pay - Paid time off, including holidays and volunteer events - Health insurance coverage for you and your dependents on Day 1 - 401(k) - Tuition reimbursement, and more

Role Description The Investigator is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving the full range of products at the AmeriHealth Caritas Family of Companies (ACFC). Work Arrangement: Remote within the United States, preferably in Pennsylvania Responsibilities: - Ensures compliance with all requirements related to Special Investigation Units and fraud, waste and abuse investigations. - Conducts investigations of potential fraud, waste and/or abuse with a focus on thoroughness and attention to detail, quality, timeliness and cost control. - Conducts comprehensive interviews with providers, members and witnesses to obtain information which would be considered admissible under generally accepted criminal and civil rules of evidence. - Proactively performs research using the Internet, data analysis tools, etc., to analyze aberrant claims billing and practice patterns. - Analyzes data as part of the investigative process using available fraud detection software and corporate resources. - Represents ACFC in conducting settlement negotiations with providers, counsel and/or other associated parties. - Prepares and submits investigative reports covering all phases of the investigation. - Interprets and conveys highly technical information to others. - Establishes and maintains liaison with public officials, law enforcement and others to obtain assistance in conducting investigations. - Performs necessary functions to support all aspects of SIU investigations and responsibilities to include, but not limited to: Intake; Screening; Reviews; Referrals; Recoveries; and Provider Investigative Site Visits. Qualifications - Bachelor's degree with a minimum of two years of experience in the healthcare field working in fraud, waste, and abuse investigations and audits OR - An associate's degree, with a minimum of four years of experience working in healthcare fraud, waste, and abuse investigations and audits. - Experience and training/certifications commensurate with position requirements in lieu of formal educational requirements for the SIU Investigator position may be considered. - Valid driver’s license required. - Experience with Data Analytics preferred. - Ability to work independently with minimal supervision, and manage a high volume of assignments. - Strong verbal and written communication skills. - High degree of integrity and confidentiality required handling information that is considered personal and confidential. - Analytical skills and ability to make deductions; logical and sequential thinker. - A minimum of 3-5 years experience conducting comprehensive health care fraud investigations; interacting with state, federal and local law enforcement agencies. Requirements - Health care industry and/or Medicare/Medicaid/Pharmacy/Behavioral Health/Pharmacy Benefit Management knowledge required. - Clinical Experience preferred. - SIU and/or State Medicaid regulatory compliance work experience preferred. - Knowledge and proficiency in claims adjudication standards & procedures preferred. - Solid knowledge of Medicaid, Medicare, and pharmacy benefit laws and requirements; federal, state, civil and criminal statutes. - Experience with decision support tools used for data analysis. - Advanced knowledge and experience working on various approaches to fraud, waste and abuse. - Working knowledge of Microsoft applications, especially Excel required. - Knowledge of available resources (internal and external) to assist in investigations. Benefits - Flexible work solutions including remote options, hybrid work schedules. - Competitive pay. - Paid time off including holidays and volunteer events. - Health insurance coverage for you and your dependents on Day 1. - 401(k). - Tuition reimbursement and more.

Role Description The Pharmacy Technician I supports the organization’s mission and purpose by providing front-line customer support for a diverse portfolio of customers. The incumbent will handle inbound telephone inquiries from Members, pharmacies, and Prescribers in our National Customer Care Center, and will consistently meet established productivity, schedule adherence, and quality standards. Work Arrangement: Remote Responsibilities - Provide real-time support to pharmacies with point-of-service inquiries - Educate prescribers on formulary and prior authorization processes - Enter customer data and other relevant information into our documentation tool - Assist members with pharmacy benefit inquiries - Adhere to standard operating procedures to ensure contact handling accuracy and operational effectiveness - Effectively communicate issues and resolutions to customers and appropriate internal staff Qualifications - Bachelor's degree or equivalent experience required - Minimum three (3) years of current/recent PBM and/or current/recent pharmacy experience required Requirements - Active/current National Pharmacy Technician Certification (NHA or PTCB) or ability to obtain one within the first six (6) months of employment is required Benefits - Flexible work solutions include remote options - Competitive pay - Paid Time Off (PTO), including holidays and volunteer events - Health insurance coverage for you and your dependents on Day 1 - 401(k) - Tuition reimbursement - And more