Client Resolution Advocate

Location: Remote (For Non-Local) or Hybrid (Local to NYC or Denver area)

Position Summary:

As a Client Resolution Advocate, you will manage a client portfolio as the primary link between Customer Care and all internal support units. You will be responsible for escalated issue resolution, agent support, and client support. Additionally, you will work closely with all support vendors to ensure seamless service to members, patients, providers, pharmacies, and clients. The Client Resolution Advocate also provides first line support for all patient inquiries regarding financial assistance funding/programs and works with them to secure funding. The ideal candidate will demonstrate strong business acumen, relationship management skills, problem-solving abilities, and effective communication. You should be comfortable working independently or collaboratively in a dynamic, highly complex, and sometimes challenging environment.

Position Responsibilities:

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  Manage all client escalations across the book of business, meeting all expected metrics, objectives and producing excellent outcomes.

  
  

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  Assist patients in accessing available financial assistance programs by working directly with them to explain the qualification criteria and gather all the information needed to complete and submit applications to the PAPs. Continuously monitor member status and act or communicate accordingly.

  
  

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  Interact directly with all Clients, Pharmacies, Providers, Consultants, and Members/Patients.

  
  

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  Foster strong relationships with all workgroups, both internally and externally.

  
  

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  Resolve issues within defined timeframes.

  
  

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  Support training programs for client implementations and new hires.

  
  

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  Collaborate with internal teams for continuous improvement.

  
  

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  Identify root causes of issues and proactively address opportunities for improvement.

  
  

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  Assist patients in accessing financial aid programs for specialty medications.

  
  

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  Ensure seamless communication between stakeholders for quality care and adherence to standards.

  
  

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  Uphold company policies and regulatory guidelines.

  
  

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  Support fraud, waste and abuse prevention initiatives.

  
  

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  Perform other customer support tasks as required.

  
  

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  Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

  
  

Minimum Qualifications:

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  2+ years of call center operations experience.

  
  

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  Familiarity with and agreement to adhere to all HIPAA guidelines and regulations.

  
  

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  Previous exposure to a complex healthcare call center operation.

  
  

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  Excellent customer service and communication skills.

  
  

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  Ability to develop people and processes.

  
  

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  Excellent organizational and time management skills.

  
  

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  Adaptability to changing priorities.

  
  

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  Strong attention to detail.

  
  

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  Ability to work independently in a fast-paced environment.

  
  

Preferred Qualifications:

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  National PTCB Pharmacy Technician certification preferred.

  
  

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  Bachelor's degree preferred or equivalent experience.

  
  

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  Experience with contact center technology is a plus.

  
  

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  Experience in medication funding programs preferred.

  
  

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  Bilingual in Spanish preferred.

  
  

All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

About Capital Rx

Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi, the company's cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.