
PrudentRx
Remote Jobs
12 Jobs
Role Description Are you looking for a position where you can tactfully and empathetically assist patient members in navigating and enrolling in their life-changing copay assistant programs? Do you enjoy a routine environment where you help people, solve problems, and make every call count? Then, join the PrudentRx call center team as a Member Enrollment Coordinator, where you’ll be a trusted guide for members navigating the copay territory and gracefully impacting lives every day through inbound & outbound calls. This role is perfect for someone who thrives in a fast-paced call center, values accuracy and compassion, and takes pride in delivering first-call resolutions. This role requires the daily utilization of interpersonal, computer, and problem-solving skills with a desire to be a team player in assisting others. In addition, you will be joining a growing company that will give you the opportunity to impact your callers and co-workers every day. Responsibilities - Work inbound and outbound member calls, assisting with the enrollment process. - Act as a subject matter expert to provide members with clear, accurate, and up-to-date information regarding program eligibility, requirements, and other enrollment needs. - Provide members with tactful and compassionate support throughout the enrollment process (while maintaining professionalism). - Escalate unresolved cases and pending member grievances. - Utilize the Salesforce CRM database to verify member data to complete enrollment. - Generate detailed records and notes of inquiries, comments, and interactions via CRM. - Work assigned queues and/or cases as directed by call center leadership. - Complete all necessary continued learning and training requirements per department and company need. - Other essential duties as assigned. Qualifications - High School Diploma or GED. - 1 to 2 years of recent Call Center experience in a fast-paced setting. - Professional, clear, and compassionate phone demeanor and attitude at all times. - Computer navigation skills, including multiple screens, simultaneous systems use, phone and CRM systems. - Ability to maintain a high level of confidentiality and always remain HIPAA compliant. - Excellent verbal and written communication skills for both note-taking and call purposes. Requirements - Experience with Salesforce or other CRM software (preferred). - Certified Pharmacy Tech (CPhT) or healthcare customer service a plus (preferred). - Bi-lingual in English/Spanish is a plus (preferred). - (200/200 mpbs) to execute all job functions. - Must provide a private workspace with a desk and chair, free from distraction. Benefits - Eligible for benefits within 30 days. - Health (family). - Dental. - Vision. - STD, LTD, Critical Illness and Accident. - Company Paid Life Insurance. - Company Paid Holidays (6). - PTO. - Tuition Reimbursement. - 401(k) 100% company match up to 4% after 90 days.
Role Description The Delivery Manager is responsible for ensuring consistent, predictable delivery of business outcomes, through software and technology, by aligning people, priorities, and processes across all domains. This role operates as the central point of accountability for delivery performance, partnering with Product Owners (POs), engineering teams, and business stakeholders to ensure that prioritized work is executed efficiently and effectively. - LMA (Lead, Manage, and Hold Accountable) - Capacity & Resource Optimization - Delivery System Performance - Cross-Domain Coordination - Process & Performance Excellence - Execution of Company Priorities - Lead, manage, and hold accountable Product Owners and Scrum Masters to ensure successful execution of work. - Optimize and rebalance resources (development, QA, data, Salesforce) across domains and pods to meet changing demand. - Monitor and improve delivery system performance, including sprint reliability, throughput, and cycle time. - Identify and resolve cross-domain conflicts, dependencies, and resource constraints. - Standardize and continuously improve delivery processes, reporting, and operational practices. - Ensure that prioritized work is properly staffed, sequenced, and delivered. - Partner with Scrum Masters to maintain consistency in Agile practices across teams. - Establish and monitor KPIs related to delivery performance and system health. - Provide transparency into delivery risks, capacity, and performance to leadership and stakeholders. Qualifications - Bachelor’s degree in Business, Information Systems, Computer Science, or related field (or equivalent experience). - 7+ years of experience in technology delivery, program management, or related roles. - 3+ years of leadership experience managing cross-functional teams. - Strong understanding of Agile and hybrid delivery methodologies. - Proven ability to manage competing priorities and optimize delivery performance. - Excellent communication and stakeholder management skills. - Proficiency with Agile delivery tools (e.g., Jira, Azure DevOps). Requirements - Experience in healthcare, SaaS, or enterprise technology environments. - Familiarity with EOS (Entrepreneurial Operating System) principles. - Experience implementing delivery metrics and performance management frameworks. Work From Home Requirements - The employee must provide reliable, high-speed internet (200 Mbps minimum) and a private workspace suitable for professional work. Physical Demands and Working Conditions Work is performed primarily in a home office setting using company-provided equipment. Duties include sitting, speaking, and using hands for computer work. Occasional standing and walking may be required. Reasonable accommodations may be made.
• Review and analyze claims to identify claims that may have been improperly billed to the COB plan for further investigation • Ensures data is accurate and updated for efficient claims processing • Monitor claims to ensure co-pay cards are utilized and billed properly • Research, identify, and communicate errors • Verify co-pay card fund availability • Maintain current knowledge of various types of COB and third-party payer rules • Meet all regulatory, contractual, or other requirements • Other duties as assigned
Role Description Are you looking for a 100% work-from-home position where you can tactfully and empathetically assist patient members in navigating and enrolling in their life-changing copay assistant programs? Do you enjoy a predictable environment where you help people, solve problems, and make every call count? Then, join the PrudentRx call center team as a Member Care Specialist, where you’ll be a trusted guide for members navigating the copay territory and gracefully impacting lives every day. This role is perfect for someone who thrives in a fast-paced call center, values accuracy and compassion, and takes pride in delivering first-call resolutions. This role requires the daily utilization of interpersonal, computer, and problem-solving skills with a desire to be a team player in assisting others. In addition, you will be joining a growing company that will give you the opportunity to impact your callers and co-workers every day. Position Details - Location: United States - Remote - Shift availability: Monday - Saturday (with one weekday off), shift times start as early as 11:30 am EST. [Accepting applicants in EST and CST time zone] - Hourly/Non-Exempt - Equipment and hardware provided. Interviewing, orientation, and training are conducted virtually. Responsibilities - Work inbound and outbound member calls, assisting with the enrollment process. - Act as a subject matter expert to provide members with clear, accurate, and up-to-date information regarding program eligibility, requirements, and other enrollment needs. - Provide members with tactful and compassionate support throughout the enrollment process (while maintaining professionalism). - Escalate unresolved cases and pending member grievances. - Utilize the Salesforce CRM database to verify member data to complete enrollment. - Generate detailed records and notes of inquiries, comments, and interactions via CRM. - Work assigned queues and/or cases as directed by call center leadership. - Complete all necessary continued learning and training requirements per department and company need. - Other essential duties as assigned. Qualifications - High School Diploma or GED - 1 to 2 years of recent Call Center experience in a fast-paced setting - Professional, clear, and compassionate phone demeanor and attitude at all times - Computer navigation skills, including multiple screens, simultaneous systems use, phone and CRM systems - Ability to maintain a high level of confidentiality and always remain HIPAA compliant - Excellent verbal and written communication skills for both note-taking and call purposes Preferred - Experience with Salesforce or other CRM software - Certified Pharmacy Tech (CPhT) or healthcare customer service a plus - Bi-lingual in English/Spanish is a plus Work From Home Requirement - Internet speed of 200/200 mpbs to execute all job functions. - Must provide a private workspace with a desk and chair, free from distraction. Physical Demands and Working Conditions - Duties are performed primarily in a home office setting utilizing Company provided computer equipment. - While performing the duties of this job, you will regularly sit and talk. - The employee is frequently required to use their hands. - Employee will occasionally be required to stand and walk. Benefits - Eligible for benefits within 30 days - Health (family) - Dental - Vision - STD, LTD, Critical Illness and Accident - Company Paid Life Insurance - Company Paid Holidays (6) - PTO - Tuition Reimbursement - 401(k) 100% company match up to 4% after 90 days
As an HR Testing Specialist: Tier 1, you will be responsible for providing detailed assistance in updating testing models. This will require exceptional project management skills in order to ensure successful go-live dates are met flawlessly. Additional strengths required for this role include out-of-the-box thinking, problem-solving skills, and attention to detail for procedure-based responsibility. A seasoned HR Testing Specialist is well-versed in system implementation and rollout efforts for existing and new departments, as well as has extensive experience with focus groups. Position Details • United States - Remote/Telecommute • 9-5 Must be in an eastern or central time zone • Equipment and hardware provided. Interviewing, orientation, and training are conducted virtually Responsibilities • Successful project completion and go-live date • Designing and educating training materials, including but not limited to manuals and system modules • Assemble, track, and prepare all focus group initiatives, including data collection, material distribution, marketing, and all analytical efforts • Content creation using systems such as Adobe, Motivosity, iMovie, and other editing sites Requirements and Qualifications • 2-3 years of experience with department development • 1-2 years of systems, SOP's, policies, and procedures development • Project management skills • Associate's degree or higher Work From Home Requirements Must provide your own reliable, high-speed internet with sufficient bandwidth (25/25mp) as well as, a private and professional workspace free from distraction, with a desk and chair to execute all job functions. Physical Demands and Working Conditions Duties are performed utilizing computer equipment including talking on the phone and keyboard usage. While performing the duties of this job, the employee is regularly required to sit and talk for prolonged periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits • Health • Dental • Vision • STD, LTD, Critical Illness and Accident • Company Paid Life Insurance • 401(k) 100% company match up to 4% 90 days
As an HR Testing Specialist: Tier 1, you will be responsible for providing detailed assistance in updating testing models. This will require exceptional project management skills in order to ensure successful go-live dates are met flawlessly. Additional strengths required for this role include out-of-the-box thinking, problem-solving skills, and attention to detail for procedure-based responsibility. A seasoned HR Testing Specialist is well-versed in system implementation and rollout efforts for existing and new departments, as well as has extensive experience with focus groups. Position Details • United States - Remote/Telecommute • 9-5 Must be in an eastern or central time zone • Equipment and hardware provided. Interviewing, orientation, and training are conducted virtually Responsibilities • Successful project completion and go-live date • Designing and educating training materials, including but not limited to manuals and system modules • Assemble, track, and prepare all focus group initiatives, including data collection, material distribution, marketing, and all analytical efforts • Content creation using systems such as Adobe, Motivosity, iMovie, and other editing sites Requirements and Qualifications • 2-3 years of experience with department development • 1-2 years of systems, SOP's, policies, and procedures development • Project management skills • Associate's degree or higher Work From Home Requirements Must provide your own reliable, high-speed internet with sufficient bandwidth (25/25mp) as well as, a private and professional workspace free from distraction, with a desk and chair to execute all job functions. Physical Demands and Working Conditions Duties are performed utilizing computer equipment including talking on the phone and keyboard usage. While performing the duties of this job, the employee is regularly required to sit and talk for prolonged periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits • Health • Dental • Vision • STD, LTD, Critical Illness and Accident • Company Paid Life Insurance • 401(k) 100% company match up to 4% 90 days
As an HR Testing Specialist: Tier 1, you will be responsible for providing detailed assistance in updating testing models. This will require exceptional project management skills in order to ensure successful go-live dates are met flawlessly. Additional strengths required for this role include out-of-the-box thinking, problem-solving skills, and attention to detail for procedure-based responsibility. A seasoned HR Testing Specialist is well-versed in system implementation and rollout efforts for existing and new departments, as well as has extensive experience with focus groups. Position Details • United States - Remote/Telecommute • 9-5 Must be in an eastern or central time zone • Equipment and hardware provided. Interviewing, orientation, and training are conducted virtually Responsibilities • Successful project completion and go-live date • Designing and educating training materials, including but not limited to manuals and system modules • Assemble, track, and prepare all focus group initiatives, including data collection, material distribution, marketing, and all analytical efforts • Content creation using systems such as Adobe, Motivosity, iMovie, and other editing sites Requirements and Qualifications • 2-3 years of experience with department development • 1-2 years of systems, SOP's, policies, and procedures development • Project management skills • Associate's degree or higher Work From Home Requirements Must provide your own reliable, high-speed internet with sufficient bandwidth (25/25mp) as well as, a private and professional workspace free from distraction, with a desk and chair to execute all job functions. Physical Demands and Working Conditions Duties are performed utilizing computer equipment including talking on the phone and keyboard usage. While performing the duties of this job, the employee is regularly required to sit and talk for prolonged periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits • Health • Dental • Vision • STD, LTD, Critical Illness and Accident • Company Paid Life Insurance • 401(k) 100% company match up to 4% 90 days
As an HR Testing Specialist: Tier 1, you will be responsible for providing detailed assistance in updating testing models. This will require exceptional project management skills in order to ensure successful go-live dates are met flawlessly. Additional strengths required for this role include out-of-the-box thinking, problem-solving skills, and attention to detail for procedure-based responsibility. A seasoned HR Testing Specialist is well-versed in system implementation and rollout efforts for existing and new departments, as well as has extensive experience with focus groups. Position Details • United States - Remote/Telecommute • 9-5 Must be in an eastern or central time zone • Equipment and hardware provided. Interviewing, orientation, and training are conducted virtually Responsibilities • Successful project completion and go-live date • Designing and educating training materials, including but not limited to manuals and system modules • Assemble, track, and prepare all focus group initiatives, including data collection, material distribution, marketing, and all analytical efforts • Content creation using systems such as Adobe, Motivosity, iMovie, and other editing sites Requirements and Qualifications • 2-3 years of experience with department development • 1-2 years of systems, SOP's, policies, and procedures development • Project management skills • Associate's degree or higher Work From Home Requirements Must provide your own reliable, high-speed internet with sufficient bandwidth (25/25mp) as well as, a private and professional workspace free from distraction, with a desk and chair to execute all job functions. Physical Demands and Working Conditions Duties are performed utilizing computer equipment including talking on the phone and keyboard usage. While performing the duties of this job, the employee is regularly required to sit and talk for prolonged periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits • Health • Dental • Vision • STD, LTD, Critical Illness and Accident • Company Paid Life Insurance • 401(k) 100% company match up to 4% 90 days
As an HR Testing Specialist: Tier 1, you will be responsible for providing detailed assistance in updating testing models. This will require exceptional project management skills in order to ensure successful go-live dates are met flawlessly. Additional strengths required for this role include out-of-the-box thinking, problem-solving skills, and attention to detail for procedure-based responsibility. A seasoned HR Testing Specialist is well-versed in system implementation and rollout efforts for existing and new departments, as well as has extensive experience with focus groups. Position Details • United States - Remote/Telecommute • 9-5 Must be in an eastern or central time zone • Equipment and hardware provided. Interviewing, orientation, and training are conducted virtually Responsibilities • Successful project completion and go-live date • Designing and educating training materials, including but not limited to manuals and system modules • Assemble, track, and prepare all focus group initiatives, including data collection, material distribution, marketing, and all analytical efforts • Content creation using systems such as Adobe, Motivosity, iMovie, and other editing sites Requirements and Qualifications • 2-3 years of experience with department development • 1-2 years of systems, SOP's, policies, and procedures development • Project management skills • Associate's degree or higher Work From Home Requirements Must provide your own reliable, high-speed internet with sufficient bandwidth (25/25mp) as well as, a private and professional workspace free from distraction, with a desk and chair to execute all job functions. Physical Demands and Working Conditions Duties are performed utilizing computer equipment including talking on the phone and keyboard usage. While performing the duties of this job, the employee is regularly required to sit and talk for prolonged periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits • Health • Dental • Vision • STD, LTD, Critical Illness and Accident • Company Paid Life Insurance • 401(k) 100% company match up to 4% 90 days
As an HR Testing Specialist: Tier 1, you will be responsible for providing detailed assistance in updating testing models. This will require exceptional project management skills in order to ensure successful go-live dates are met flawlessly. Additional strengths required for this role include out-of-the-box thinking, problem-solving skills, and attention to detail for procedure-based responsibility. A seasoned HR Testing Specialist is well-versed in system implementation and rollout efforts for existing and new departments, as well as has extensive experience with focus groups. Position Details • United States - Remote/Telecommute • 9-5 Must be in an eastern or central time zone • Equipment and hardware provided. Interviewing, orientation, and training are conducted virtually Responsibilities • Successful project completion and go-live date • Designing and educating training materials, including but not limited to manuals and system modules • Assemble, track, and prepare all focus group initiatives, including data collection, material distribution, marketing, and all analytical efforts • Content creation using systems such as Adobe, Motivosity, iMovie, and other editing sites Requirements and Qualifications • 2-3 years of experience with department development • 1-2 years of systems, SOP's, policies, and procedures development • Project management skills • Associate's degree or higher Work From Home Requirements Must provide your own reliable, high-speed internet with sufficient bandwidth (25/25mp) as well as, a private and professional workspace free from distraction, with a desk and chair to execute all job functions. Physical Demands and Working Conditions Duties are performed utilizing computer equipment including talking on the phone and keyboard usage. While performing the duties of this job, the employee is regularly required to sit and talk for prolonged periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits • Health • Dental • Vision • STD, LTD, Critical Illness and Accident • Company Paid Life Insurance • 401(k) 100% company match up to 4% 90 days
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