
Maxor National Pharmacy Services, LLC
Remote Jobs
35 Jobs
• Process and support daily/weekly client batch file updates working directly with account managers, implementation teams and clients. • Conduct member and file research, file processing, manual updates, data analysis, troubleshoot and resolve integration and data quality issues. • Demonstrate knowledge of VytlOne’s PBM platform, application, file integration functions/standards and client specific configurations. • Handle routine work stream assignments and ensure quality, service levels, productivity and customer standards are consistently met. • Comply with VytlOne’s Ethical Business Conduct policy and VytlOne’s Compliance Program. • Maintain regular attendance in accordance with established policies. • Perform other job-related duties as assigned.
• Interpret and fill drug orders accurately and timely • Ensures the appropriateness of all medication orders, new prescriptions or refills, in reference to the client’s diagnosis, weight/body surface area, allergies, and drug interactions as evidenced by a review of the active medication profile, provider notes, and available pertinent laboratory information. • Conduct/Review Drug Utilization Reviews to check for drug duplication, interactions or allergies. • Review non-formulary drug requests using predetermined criteria. • Review prior authorization requests using predetermined criteria. • Maintain current knowledge of drug therapies and drug reactions and interactions by reading professional literature, attending seminars and through professional affiliations. • Contact and confer with physicians regarding questions or irregularities with prescription practice whenever safety or established alternatives have not been utilized. • Monitor drug therapy for contraindications, interactions, allergies and appropriateness. • Documents / maintains initial patient assessments, reassessments and care management plans in the electronic patient management program, e.g., Asembia, CPR Plus. • Provide drug information to meet the needs of medical and nursing staff members through direct contact or in-service programs. • Provide patient information and counseling. • Participate as an active member and facilitator in process improvement teams. • Prepare provider newsletters or articles to keep providers updated. • Provide individual and group training, in-services and other consultations to unit staff and providers to optimize therapy. • Work with medical directors and staff in developing and carrying out various clinical initiatives. • Generate and review standard monthly and quarterly reports, as required. • Attend and participate in other programs, committees, meetings, and functions as required. • Assist in the development of clinical, utilization management, ad hoc and production reports and programs. • Assist in formulary, rebate analyses and pharmacoeconomic studies and initiatives. • Perform retrospective drug utilization review: identify drug, physician, and patient utilization trends; make interventions as appropriate; monitor and document outcomes. • Assist in the generation, maintenance, and distribution of formulary alternative lists, maintenance drug lists, and new drug to market lists. • Work cooperatively with other staff members to enhance the team concept. • Supervise pharmacy technicians in the routine performance of their duties. • Participate in the development and implementation of the Performance Improvement Program. • Assist in overseeing clinical procedures. • Complete facility audits as assigned. • Maintain regular attendance in accordance with established policies and procedures. • Perform other job-related duties as assigned. • Promptly report any allegations of impropriety to the Compliance Department. • Comply with VytlOne’s Ethical Business Conduct policy and VytlOne’s Compliance Program. • Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists. • Complete required training, as assigned, within the established timeframes. • Designated Person Only – Serve as the Designated Person by completing and maintaining all required training and certifications to ensure compliance with USP , USP , and all applicable company policies and procedures.
• Investigate, analyze, and resolve hardware and associated software and communications problems with computer systems • Perform complex hardware repairs and maintenance on a wide range of PC-based computers and peripherals • Provide advanced hardware technical assistance and support • Troubleshoot and resolve system hardware, software, and communications failures and conflicts • Install, integrate, and configure new computer systems and hardware for users • Provision, modify, and deprovision user access for systems and applications in accordance with access policies and documented standard operating procedures • Review, prioritize, and process problem reports; document the progress of projects. • Document technical processes and support procedures and contribute to standardization to ensure consistency, efficiency, and knowledge sharing • Assist in multiple audits: Quarterly system access, software, licensing • Maintain a high-level quality of customer service standards in dealing with and responding to questions. • Perform other job-related duties as assigned. • Follow Procedures for call length, and escalation process • Resolve Tickets to meet set SLA’s
Role Description The IT Service Technician uses specialized knowledge & skills to perform hardware support and repairs for user departments across the company. The IT Service Technician resolves hardware, software, and communication problems/conflicts/defects. - Investigate, analyze, and resolve hardware and associated software and communications problems with computer systems. - Perform complex hardware repairs and maintenance on a wide range of PC-based computers and peripherals. - Provide advanced hardware technical assistance and support. - Troubleshoot and resolve system hardware, software, and communications failures and conflicts. - Install, integrate, and configure new computer systems and hardware for users. - Provision, modify, and deprovision user access for systems and applications in accordance with access policies and documented standard operating procedures. - Review, prioritize, and process problem reports; document the progress of projects. - Document technical processes and support procedures and contribute to standardization to ensure consistency, efficiency, and knowledge sharing. - Assist in multiple audits: Quarterly system access, software, licensing. - Maintain a high-level quality of customer service standards in dealing with and responding to questions. - Perform other job-related duties as assigned. - Follow Procedures for call length, and escalation process. - Resolve Tickets to meet set SLA’s. Qualifications - High School graduation or equivalent is required. - Bachelor’s Degree in Management Information Systems, Computer Science or related field or equivalent technical/vocational certification or equivalent experience is preferred. - 1-2 years PC maintenance/repair, application software support. - Knowledge of Microsoft Office software products required. - Software and hardware certifications a plus. - Knowledge of Incident Technology Infrastructure Library (ITIL) or Cobit framework. - Retail pharmacy operations desirable. - Experience working in a corporate business environment desirable. Requirements - Ability to perform advanced complex repairs and upgrades on a wide variety of computers and peripherals. - Knowledge of a wide range of computer systems software, applications, hardware, and communications. - Ability to simultaneously coordinate and complete multiple projects. - Knowledge of advanced computer-troubleshooting techniques. - Ability to diagnose the nature and extent of a wide range of computer problems. - Ability to install and configure computer systems, hardware, and peripherals. - Ability to make administrative/procedural decisions and judgments. - Knowledge of customer service standards and procedures. - Demonstrated leadership potential. - Demonstrated ability to be self-motivated with a positive attitude. - Demonstrated ability to mentor co-workers to help the team succeed. Benefits - Diverse and inclusive work culture that supports a flexible work model. - Competitive compensation and a comprehensive health benefits package. - Comprehensive mental health and wellbeing resources. - Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design. - Company-paid basic life/AD&D, short-term and long-term disability insurance. - Rx, dental, vision, other voluntary benefits, and FSA. - Employer-matched 401k Plan. - Industry-leading PTO plan. - And more!
• Audit and review workflows, processes, assessments, and related documentation • Evaluate calls using voice and screen recordings • Assess competencies across job roles • Collect and review quality measures on a monthly, quarterly, and annual basis • Review reports and statistics to support digital applications • Perform quality checks on websites and other technology links • Support the Rare and Orphan Care Team, as assigned • Complete additional quality-related monitoring, as needed • Ensure compliance with the VytlOne Business Code of Conduct and all company policies and procedures • Report allegations of impropriety promptly to the Compliance Department • Comply with VytlOne’s Ethical Business Conduct Policy and Compliance Program • Remain free from exclusion under the OIG and SAM Medicare/Medicaid lists • Complete required training within established timeframes • Ability to cope with the mental and emotional stress of the position • Maintain regular attendance in accordance with policy • Perform other job-related duties, as assigned.
• Lead process improvement initiatives across the Client Services division to increase compliance, efficiency, and quality assurance. • Identify, map, analyze, and redesign operational workflows; document current and future state processes with clear standards and controls. • Continuously monitor existing processes for opportunities to reduce friction, standardize practices, and improve team performance. • Maintain a complete and current library of process documentation for Client Services operations. • Gather requirements, build project timelines, assign accountability, and drive completion of internal improvement initiatives. • Lead high-priority, one-time client-facing projects in coordination with the Client Services team. • Oversee complex, cross-functional projects requiring coordination across Client Services, Operations, Finance, Clinical, and Marketing. • Track and report on project status, risks, and outcomes to relevant stakeholders and leadership. • Manage all aspects of third-party vendor relationships including procurement standards, contract compliance, onboarding, and ongoing operational oversight. • Serve as the primary internal point of contact for vendor escalations and performance issues. • Evaluate vendor performance against established standards and make recommendations for changes as needed. • Create and maintain client- and member-facing marketing materials including PowerPoint presentations, flyers, brochures, and email communications. • Ensure all materials reflect current VytlOne branding, product updates, and regulatory requirements. • Develop and distribute internal Client Services communications as needed, including team announcements, product updates, and process change notifications. • Comply with VytlOne’s Ethical Business Conduct policy and Compliance Program. • Promptly report any allegations of impropriety to the Compliance Department. • Remain free from exclusion under OIG and SAM Medicare/Medicaid lists. • Complete all required training within established timeframes.
Role Description VytlOne is currently seeking highly motivated and empathetic Member Advocates to join our dynamic, growing operations team. As the voice of our brand, this role handles complex customer inquiries that require a human touch, leveraging systems and tools to provide efficient and personalized solutions. The ideal candidate thrives in a fast-paced environment, has strong critical thinking skills, and is passionate about turning challenging interactions into positive brand-building opportunities. The Member Advocate is responsible for establishing and maintaining relationships with members on behalf of the company by taking personal and complete responsibility for each member-related contact and ensuring that all member and client requirements are completely met. As a Member Advocate, you are the primary internal representative of our organization; you must convey to the caller (member, pharmacy, provider, client, or other) a sense of expertise in our services. Position Location: This is a remote-based position within the Continental US. Responsibilities - Field complex inbound inquiries, emails, and chat messages with professionalism and empathy. - Efficiently and creatively resolve customer complaints, escalating complex issues to the appropriate channels when necessary. - Maintain deep job and service knowledge to confidently and accurately educate and serve members according to VytlOne standards. - Meet or exceed key performance metrics to include, but not limited to: - QA Scores - Member Satisfaction Survey Scores - Average Handle Time (AHT) - Schedule Adherence - Attendance Standards - Remain flexible and composed while navigating different member personalities, unpredictable call volumes, and changing procedures. - Maintain meticulous and accurate records of customer interactions within the CRM and AI tools, contributing valuable data for process improvement. - Proactively identify trends in customer feedback and issues, providing insights to management to streamline processes and enhance the member experience. - Partner with AI-powered tools (e.g., AI copilots, knowledge bases) to access real-time information, generate call summaries, and personalize member interactions. - Maintain an open line of communication with all team members, including Member Services Management and Lead Member Advocate. - Attend and participate in programs and meetings required by VytlOne and/or Member Services Department. - Promptly report any allegations of impropriety to the Compliance Department. - Comply with VytlOne’s Ethical Business Conduct policy and VytlOne’s Compliance Program. - Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists. - Perform other job-related duties as assigned. Qualifications - High school diploma, GED, or equivalent. - 2+ years Pharmacy or Health Care customer service experience (required). - Experience with PBM Contact Center, Chat Support, AI, and CRM technologies (preferred). - Strong interpersonal skills to build rapport, actively listen, and tailor service to member emotions and intent. - Excellent verbal and written communication skills, with a professional, collaborative, and friendly demeanor. - A proactive and efficient problem-solver who can think through complex situations and offer creative, effective solutions. - Must be open to receiving feedback on performance which will be provided by the quality team, team leads, supervisors, manager, and VP. - Proficiency with computers and the ability to navigate multiple systems simultaneously, including CRM, AI tools, and Contact Center software. - The ability to manage stress and stay composed, especially in challenging situations. - Punctuality and dependable attendance are essential to meet operational needs. - Ability to learn new skills, tasks, and technology. - Strong ability to integrate into a team environment, collaborate with diverse work styles, and positively contribute to organizational culture. - A tech-forward mindset and the ability to leverage AI-powered platforms and digital tools to enhance efficiency. Requirements - Scheduling flexibility is a requirement; may be required to work rotating shifts, including Holidays, weekends, and nights. Some overtime may be required. - A reliable, high-speed internet connection (preferably wired), a dedicated, distraction-free workspace, and proficiency with remote communication tools are essential. - You will be provided with all the tools needed to perform your role, including dual monitors, laptop, and headset. Benefits - Diverse and inclusive work culture that supports a flexible work model in a collaborative, innovative team-oriented environment. - Competitive compensation. - Comprehensive health benefits package, including: - Comprehensive mental health and wellbeing resources. - Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums. - Company-paid basic life/AD&D, short-term and long-term disability insurance. - Rx, dental, vision, other voluntary benefits, and FSA. - Employer-matched 401k Plan. - Industry-leading PTO plan. - Opportunity to help build the future of pharmacy care – better outcomes, stronger margins, and healthier communities.
• Work in conjunction with the Operations Manager to assure compliance with service expectations and achievement of performance goals and objectives • Prepare reports and maintain records/maintain records as requested or required • Develop, implement, and deliver training programs for all levels of pharmacy personnel • Coordinate training schedule with members of management • Develop and maintain continual education support materials to assist the pharmacy staff in learning the specialized pharmacy systems • Confer with management, supervisors and employees to gain knowledge of work situations requiring training and to better understand changes in policies, procedures, regulations, and/or business technologies • Test trainees to measure progress and to evaluate effectiveness of training • Frequently report on progress of employees under guidance during training periods • Participates in the maintenance of corporate compliance and legal board of pharmacy inspection parameters • Monitor methods used by employees for Guardian Rx and/or POS and make on the spot corrections when needed • Assist employees with problems concerning “how to” perform specific tasks related to the pharmacy systems • Assists with staff training and the implementation of processes related to meeting accreditation standards
• Oversee and coordinate key operational functions to ensure organizational efficiency and alignment with strategic goals • Manage and organize operational projects, leads the planning and coordination of daily activities and meetings • Support productive vendor relationships • Maintain current accreditations, develops and organizes training materials • Monitor and manage open internal and external IT items and tickets to drive timely resolution and continuous process improvement • Demonstrate integrity and accountability in compliance obligations • Support the compliance with VytlOne Business Code of Conduct, as well as other company policies and procedures
• Responding to end-user inquiries that may be received by phone calls, email, chats, and ticket requests for support to resolve pharmacy systems, claim adjudications, and issues with VytlOne Bolt-on’s • Accessing product information or the solution database to research, troubleshoot, and deliver solutions • Advising users on the methods, steps, and actions to resolve and avoid future issues and provides documentation as needed • Documents incidents using ticketing system • Escalates problems to appropriate levels or teams to achieve issue resolution • May support upgrades of software or devices, set up user profiles, or re-set passwords • Fulfills all service level standards for response time and quality • Establishing and maintaining relationships with end users on behalf of the company
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