Assist in formulary management by overseeing prior authorization processes and utilization review reporting. Communicate effectively with healthcare professionals and prepare necessary documentation while administering appeals and grievances.

• Responds to telephone inquiries from providers on subscriber verification, benefit eligibility, plan maximums, requirement of prior approvals and claim inquiries • Verifies claims through online adjudication systems • Makes suggestions for ways of improving workflows and processes • Records and forwards provider feedback to the appropriate Team Manager and/or Manager • Supports various projects and analyses using Excel, Word, and other computer software • Logs details of calls • Assists with other duties as required

Role Description The Pharmacy Technician is an important colleague of ArchWell Health Pharmacy Team. Reporting to the Clinical Pharmacist, the Pharmacy Technician will be providing direct patient care and collaborating with other healthcare team members in a virtual environment to optimize the pharmaceutical care for our patients. This individual will conduct patient outreaches per existing protocols and assist patients with navigating the medication use aspects, including reviewing components of their plan benefits. An ideal candidate will have a deep understanding of Medicare Advantage prescription benefits, possess strong attention to detail, and be driven by a passion for providing quality care to seniors. Duties/Responsibilities - Conduct telephonic outreaches and answer incoming calls regarding member’s medication use, including but not limited to medication adherence, refill request, and medication clarification. - Obtain member’s permission and place refill requests with pharmacies via phone or web systems. - Access medication adherence gap portals or lists and review member’s medical chart notes to determine appropriate action. - Review and process pharmacy refill requests, either via faxes, EMR routes, or direct incoming calls, per established protocol while meeting the expected turnaround time. - Collaborate with other pharmacy staff, providers, and their care teams as needed to resolve any issues or discrepancies related to medication use. - Ensure that all tasks are completed timely, documented accurately, and in accordance with regulations (including HIPAA) and organizational standards. - Attend staff meetings and provide input into current trends, process evaluation, and quality improvement. - Assist with other pharmacy departmental initiatives as they become available. - Additional duties, as assigned. Qualifications - Excellent customer service and communication skills, including telephone etiquette skills, active listening skills, and the ability to follow-through with patients or staff members. - Ability to work effectively and respectfully with colleagues and diverse populations including members, staff, providers, and family members. - High degree of emotional intelligence and integrity, resilient and focused work ethic, with adaptability to handle frequent changes with a positive attitude. - Self-starter with the ability to think creatively and work effectively. - Strong attention to detail and possessing good alpha/numeric data entry skills with minimal errors. - Intermediate proficiency in Microsoft Office Suite products including Word, Outlook and Excel plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software. - Ability to travel on occasion for company meetings. Requirements - High school diploma or equivalent education (GED) required. - Registered Pharmacy Technician with a state board of pharmacy. - A minimum of 2 years of experience in operational pharmacy benefits (health plan or PBM), clinic setting, high volume call center, or retail pharmacy. - eClinicalWorks or similar EMR experience. - Experience working with geriatric patients or a medication adherence program is a plus. - Bilingual in English/Spanish highly desired. Company Description ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities.

Role Description We're looking for an experienced clinical professional with a pharmacy or AHPRA registered nursing background to join our Medical Support team remotely. You'll be a key point of contact for patients — providing clinical support and handling medical inquiries. This role is fully remote and open to anyone based in Australia who can work Sydney hours. - Respond to patient inquiries via a ticketing system with clear, accurate, and empathetic written communication - Manage inbound calls and make outbound calls to patients to address queries, concerns, and offer support - Maintain accurate documentation of all patient interactions - Collaborate with internal teams across time zones - Deliver a high standard of patient care while adhering to regulatory and compliance requirements Qualifications - 4–7 years of clinical experience in pharmacy or nursing (AHPRA registered) - Prior experience in telehealth — you know how to deliver great care without being in the room - Proven ability to work independently and manage your own workload with minimal oversight - Excellent written communication skills with the ability to explain clinical information clearly - Excellent telephone manner and confidence handling sensitive conversations - Strong attention to detail and sound clinical judgment - Comfortable working shifts between 8am–9pm AEST, Monday–Sunday (5 days or fewer per week) Requirements - Previous experience with GLP-1 medications or weight management programs Benefits - Access learning budgets, conferences, certifications, peer shadowing, and a global knowledge-sharing culture - Equity for everyone means you share in our success - Experience catered wellness talks, exercise classes, whoops to track your wellbeing, free barista coffees, funded social clubs, and quarterly rooftop parties - Benefit from parental and miscarriage leave, to health, professional development, and personal days, Whoop membership, and our Employee Assistance Program