Position
Clinical Analyst
Description

Join our team! RxAdvance is a disruptive healthcare company that leverages an enterprise platform to transform an antiquated industry. With guidance from visionary leaders, such as John Sculley, former Apple CEO, and Oscar Salazar, co-founder of Uber, and many other healthcare and technology innovators, RxAdvance embraces innovation and entrepreneurial thought to define the future of healthcare. RxAdvance was founded with a noble cause of enabling coverage of the uninsured and underinsured, while lowering premiums for all Americans, by partially reducing the $900B of administrative and avoidable medical costs across the care continuum.

RxAdvance is seeking motivated, intelligent, mature, customer-centric, passionate, hardworking, organized, self-disciplined individuals with strong analytical and reasoning skills. Those with immense curiosity, positivity, and a bold attitude to respectfully question the status quo with rationalization will excel at RxAdvance with immense career growth potential.

Responsibilities
  • Provide support for Clinical Programs
  • Assist in configuration and analysis of benefits, formulary and utilization management
  • Research insurance benefit details for commercial, exchange, Medicare, and Medicaid payers
  • Follow all internal Policies & Procedures to ensure consistency, accuracy, and operational effectiveness
  • Keep up-to-date with industry trends and regulatory changes in the pharmacy and managed care industry
  • Interact with health plan clients’ operations teams on a regular basis to address outstanding issues and bring them to resolution
  • Work closely with diverse departments to manage daily clinical operations within schedule, scope, and quality to meet established service level agreements
  • Monitor and review state and federal healthcare polices to ensure that the platform is compliant. If gaps are identified, work with technical and clinical teams to translate state and federal regulations into configurable solutions
  • Assist in monitoring several areas of the platform, report issues/suggestions for improvement to the product team or reach out to client for resolution if necessary
  • Attend client meetings for requirements gathering, communicate to product team and validate once in production
  • Effectively communicate issues and resolutions to members, pharmacy personnel, providers, and appropriate internal staff
  • Other responsibilities as required
  • Attends required training as needed
Qualifications
  • Bachelor’s degree required, degree in healthcare, public health, biology, or related fields is required
  • 1 – 3 years of pharmacy technician experience in a retail pharmacy, PBM, hospital, clinical pharmacy, or long-term care environment is preferred
  • National Certified Pharmacy Technician (CPhT) license is preferred
  • Demonstrated track record of academic, professional, and personal success
  • Ability to visualize processes and identify core functions
  • Strong organizational skills and ability to reprioritize projects as needed
  • Desire to work closely with senior leadership in tackling complex issues
  • Excellent communication skills with an ability distill complex challenges and detailed analysis into simple, structured frameworks with actionable solutions
  • Careful attention to detail with strong analytical capabilities
  • Team player with a collaborative working style
  • Ability to multitask on different projects and timelines
  • Strong interest in healthcare and technology industries
  • Excellent communication, writing, and organizational skills with the ability to multi-task and collaborate in a team
  • Self-motivated and detail-oriented with the ability to resolve complex matter

Position: Clinical Analyst

Thank you for submitting your application. We will contact you shortly!

Job Location
Southborough
Working Hours
Full Time
Date posted
June 7, 2019