• Support members, providers, and pharmacies by responding to pharmacy-related inquiries, benefit questions, prior authorization requests, and claims-related issues • Research and resolve pharmacy claims, eligibility, coverage, and medication-related concerns while maintaining service level expectations • Review, document, and process pharmacy transactions and requests in accordance with client, regulatory, and operational guidelines • Utilize multiple systems and resources to accurately investigate issues, provide resolutions, and maintain complete documentation • Collaborate with internal teams, healthcare professionals, and external stakeholders to support quality service delivery and member satisfaction

Role Description We are looking for a Remote Clinical Care Coordinator to join our team. This work-from-home telephonic nurse role reports directly to the Director, Contact Center. The Clinical Care Coordinator is responsible for providing expert support in post-acute care navigation and serving as a knowledgeable resource on our services, including home health, hospice, and palliative care. The Clinical Care Coordinator ensures continuity of care for patients transitioning into or out of our services, determines appropriate levels of care, and educates patients and families on available post-acute care options. This position plays a critical role in connecting patients with the right services while ensuring a seamless, compassionate experience. The schedule is: - Saturday & Sunday 8pm to 8:30am - Friday 12am to 8:30am - Thursday 11am-7pm Key Responsibilities - Serve as the main point of contact for patients and families transitioning from or seeking post-acute services. - Make clinical level-of-care determinations using discussions, medical records, and other clinical data. - Provide patient education and guidance on home health, hospice, palliative care, Medicare coverage, billing, and other healthcare resources. - Act as a customer advocate throughout the referral process to ensure timely responses and maximize admissions conversion rates. - Coordinate follow-up and track referral outcomes to ensure high-quality care transitions. - Utilize multiple tools and methods to provide patient options and recommendations regarding post-acute care. - Assist in the admissions process, supporting patients who meet requirements and ensuring satisfaction with services. - Maintain awareness of departmental performance objectives and patient satisfaction goals. Qualifications - Associate degree required; Bachelor’s degree preferred. - Minimum of 3 years of post-acute care experience. - Home health and hospice experience strongly preferred. - Licensed Registered Nurse (preferred) or LPN with active professional licensure in a compact state (must be willing to obtain additional state licensure as required). - Strong knowledge of home health, hospice, and palliative care services. - Excellent communication, analytical, and customer service skills. - Strong computer and technology skills; proficiency in Microsoft Office Suite. Benefits - Competitive Pay - 401(k) with Company Match - Career Advancement Opportunities - National & Local Recognition Programs - Teammate Assistance Fund - Medical, Dental, Vision Insurance (Full-Time) - Mileage Reimbursement or Fleet Vehicle Program (Full-Time) - Generous Paid Time Off + 7 Paid Holidays (Full-Time) - Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care) (Full-Time) - Education Support & Tuition Assistance (ASN to BSN, BSN to MSN) (Full-Time) - Free Continuing Education Units (CEUs) (Full-Time) - Company-paid Life & Long-Term Disability Insurance (Full-Time) - Voluntary Benefits (Pet, Critical Illness, Accident, LTC) (Full-Time) Legalese - This is a safety-sensitive position. - Employee must meet minimum requirements to be eligible for benefits. - Where applicable, employee must meet state specific requirements. - We are proud to be an EEO employer. - We maintain a drug-free workplace.

• Use evidence-based medicine and clinical judgment to evaluate the suitability of pharmacotherapy for high-risk patients with chronic conditions, including diabetes, hypertension, heart failure and COPD • Execute clinical protocols as allowed per organization and state regulatory agencies • Optimize drug coverage benefits for appropriate care and reduced costs (preferred formulary products, lower cost alternatives and home delivery pharmacy) • Collaborate with physicians, nurses, and other healthcare professionals to improve patient care • Participate in high-risk rounds with a multi-disciplinary team to discuss patient progress and adjust treatment plans • Excellent patient counseling skills to communicate complex medical information to patients and healthcare providers • Participate in quality improvement initiatives aimed at enhancing medication safety and efficacy • Post-discharge medication reconciliation for high-risk transition of care patients • Document all activity within clinic EMR and other required pharmacy or clinical management systems • Support CMS Stars and HEDIS quality measures for successful clinic performance • Maintain accurate documentation of clinical interventions and patient care activities • Conduct in-service education sessions for healthcare staff and develop and share educational materials related to pharmacotherapy • Stay current with advancements in pharmacotherapy and clinical guidelines. • Provide consultation to healthcare providers on complex medication management issues • Respond to additional requests from the Primary Care Organization, providing support within the pharmacist's defined scope of practice to advance organizational goals. • Address and implement targeted initiatives or priorities as directed by the National Director or Associate Directors of Pharmacy, according to best practices and regulatory standards.

• Serve as the subject matter expert of their designated pharmacy center of excellence • Work alongside Pharmacy management/leadership to drive and support department efficiencies • Lead by example and support company and department goals • Drive results and achieve a consistent standard of work from the team of Pharmacists • Build team capabilities through leadership skills in a call center environment • Create, interpret, and monitor Salesforce reports and utilize RX30, Salesforce, and OnBase • Prepare and monitor follow-up with Pharmacist assignment schedule • Collaborate with internal partners to resolve patient issues • Indirectly manage/coaching peers on phone performance and metrics