Apotheco, LLC

Role Description The Central Prior Authorization Pharmacy Technician will serve as the primary coordinator for specialty medication prior authorizations (PAs), ensuring timely processing and approval of specialty drug therapies. This role will work closely with prescribers, patients, insurance providers, specialty pharmacies, and internal pharmacy teams to facilitate medication access, obtain required documentation, track authorization statuses, and support the reimbursement process. This position requires strong organizational skills, attention to detail, and knowledge of specialty pharmacy and insurance workflows. This position can be remote, home-based requiring reliable internet access and a private workspace for confidential patient interactions. Must adhere to all company policies, procedures, confidentiality standards, and security protocols applicable to remote employees. Duties and Responsibilities - Manage and process prior authorization requests for specialty medications. - Communicate with provider offices, patients, payers, and specialty pharmacies to obtain clinical documentation and authorization approvals. - Submit, monitor, and track PA requests through payer portals, fax, phone, and electronic systems. - Follow up on pending PAs, appeals, renewals, and denials to ensure timely patient access. - Verify patient insurance coverage, benefits, and specialty pharmacy requirements. - Input all necessary data into the pharmacy management system to track and maintain up-to-date project information. - Receive, analyze, gather, and organize data from multiple sources. - Accurately enter required data into one or more databases, documents, or spreadsheets. - Work closely with different functional departments including but not limited to pharmacy operations, sales, and data team. - Support all existing data projects. - Use pharmacy system to obtain patient and drug information and process prescriptions. - Manage prescription refills for integrated offices. - Apply manufacturer copay cards if applicable. Qualifications - Pharmacy Technician Experience. - Experience with specialty medications and prior authorization processes preferred. - Knowledge of commercial, Medicare, and Medicaid insurance plans. - Familiarity with specialty pharmacy workflows and reimbursement procedures. - Familiar with the prescription adjudication process. - Ability to learn pharmacy management systems to extrapolate pertinent data. - Ability to communicate effectively within various levels of the organization. Requirements - Ability to read, comprehend, and write correspondence. - Ability to effectively present information in one-on-one and small group situations to all employees of the organization. - Ability to comprehend and apply principles of basic math. - Ability to apply common sense understanding. - Strong analytical and problem-solving skills. - Excellent interpersonal, negotiation, and conflict resolution skills. - Proficient in Word and Excel or related software. - Comfortable using RingCentral and experience with patient outreach. - Experience using payer portals such as CoverMyMeds or similar authorization platforms preferred. Knowledge, Skills, and Other Abilities - Time management - Oral and written communication skills - Professionalism - Organization skills - Customer Service - Prioritizing skills - Detail-oriented - Multi-task abilities - Goal-oriented - Dependable - Confidentiality - Self-motivated - Ability to work well with various departments and within a team. - Participate in continuous quality improvement activities Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to walk, sit, and use hands. The employee is occasionally required to stand.

Role Description As the IT Intern (AI and ITSM) at Apotheco, you will bridge the gap between cutting-edge Generative AI and the rigorous compliance requirements of a regulated pharmacy group. Reporting directly to the VP of IT, this role is a 'Co-Pilot' for our digital transformation, responsible for building, testing, and scaling bespoke AI agents within our secure Enterprise AI Platform (EAP). Your objective is twofold: to drive operational efficiency using Agentic AI while serving as a frontline steward of our AI Acceptable Use Policy (IT-005). You will ensure that all AI-driven workflows at Apotheco strictly adhere to the C.A.R.E. framework, prioritizing patient confidentiality (PHI/PII) and human-verified accuracy in an auditable environment. This is a temporary part-time internship, up to 20 hrs./week. Qualifications - Currently enrolled in a university course in Computer Science, Data Science, Computer Information Systems, Engineering, or a related field. - Previous coursework or projects related to machine learning or AI is a plus. - Familiarity with cloud platforms (AWS, Google Cloud), big data technologies (Hadoop, Spark), Abacus.AI or similar AI platforms, and version control systems (Git) is beneficial. Requirements - Assist with the roll out of Enterprise AI Tools: - Become an expert in Apotheco’s selected Enterprise AI platform(s). - Develop training and reference documents and tools for use by employees that result in effective utilization of the Enterprise AI tools. - Develop, in coordination with cross-functional leaders, bespoke agents, AI model accelerators, custom chat interfaces, and automations that drive efficiencies and increase responsible utilization of AI at Apotheco. - Host regular training and information sessions and ensure the topics covered in these sessions result in the creation of reusable materials that are made available to users in accordance with Apotheco’s standards for documentation of this type. - Policy and Standards: - Develop in collaboration with IT and compliance leaders monitoring and compliance reporting that facilitates effective monitoring of AI use, and assist the VP of IT in drafting the Quarterly AI Effectiveness Assessment as mandated by the AI Acceptable Use Policy. - Document and support the implementation of standards for bespoke AI tools that ensure supportability and scalability of those tools now and into the medium term. - Testing and Evaluation of AI Models: - Assist in testing AI models to ensure they are functioning as expected. - Identify and address potential issues or inaccuracies in AI systems. - IT Support: - Participate in the implementation of Intune and Defender for Device and Endpoint management. - Assist your team members in IT as directed to facilitate the integration of AI in the development and implementation of ITSM best practices at Apotheco. - Learn the Business: - Develop a comprehensive understanding of the pharmacy delivery business and Apotheco’s market position and strategy. - Contribute new and innovative ideas and solutions that solve business problems as these opportunities arise. Benefits - Proficiency in programming languages such as Python, R, or Java. - Knowledge of AI/ML libraries like TensorFlow, PyTorch, or Scikit-learn is an advantage. - Strong understanding of statistical methods, linear algebra, and calculus to develop and evaluate machine learning models. - Familiarity with data manipulation, cleaning, and preprocessing techniques using libraries such as Pandas or Numpy. - Strong analytical thinking and problem-solving skills to troubleshoot and optimize models. - Ability to clearly communicate findings, challenges, and solutions to team members. - Experience with or coursework covering NIST AI Risk Management Framework (RMF), ISO/IEC 42001, or SOC 2 Type 2 controls in a regulated (HIPAA/SOX) environment. Company Description It is Apotheco's philosophy and policy to treat our employees and applicants for employment fairly and without regard to various protected characteristics. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Role Description As an Associate Product Manager on our innovation team, you’ll own feature delivery from ideation through launch for a core product—translating user insights and business goals into clear PRDs, wireframing and prototyping in Figma, and prioritizing and managing the product queue. You’ll partner with the Director of PM on vision and collaborate closely with engineering, project leadership, and our cross-functional partners to ensure robust, user-centric solutions, leveraging data to spot opportunities and continuously refine the product. Duties and Responsibilities - Be product driven and be able to think strategically to craft UX flows and features from the ground up—understand our users & business objectives, and champion the best solution. - Write and maintain clear PRDs, feature briefs, and tickets: translate ideas into functional requirements, acceptance criteria, and thorough designs for engineering hand-off. - Produce low- to high-fi wireframes and build clickable prototypes in Figma. - Collect & analyze product data to evaluate hypotheses and suggest new user-focused improvements to platform. - Collaborate closely with engineering, the Project Manager, and stakeholders for task planning & prioritization, development hand-offs, and release readiness. - Lead feature demos and walkthroughs for stakeholders and field product/UX questions. - Although position is fully remote there may be occasional travel for in-person company meetings and events. Qualifications - 1+ years of experience in software product management or UX role. - Moderate to advanced fluency in Figma preferred. - Experience with Mixpanel, Tableau, or other analytics tool preferred. - Strong analytical, organizational, and communication skills, both oral and written. - Creative problem solver with the ability to identify real obstacles and viable solutions. - Detailed-oriented and an eye for design. - Quick learner and flexible as every day presents unique challenges. - A willingness to get hands dirty and do whatever it takes to ensure success. - A passion for technology and software. - BA/BS preferred but not required.