In general, the Key Accounts Case Manager will be responsible for the following tasks:
Review and interpret prescriptions to ensure appropriate therapies.
Review medication policies to ensure compliance with requirements for billing purposes.
Transcribe prescription data in preparation for Pharmacist verification.
Contact all new patients to inform them of prior authorization requirements and welcome them to Alivia Specialty Pharmacy.
Gather all necessary information and documents to support the approval request to the Health Plan or PBM.
Communicate and send necessary documents to insurance companies or other payers to fulfill prior authorization requirements.
Answer incoming pharmacy calls with excellent customer service standards and follow up on pending internal or external tasks.
Meet the quantitative and qualitative production standards set by management.
Obtain the patient’s medication list for DUR research.
Submit and review prescription drug insurance claims to be delivered to patients and providers.
Refer to the Patient Assistance Program department in cases where the patient cannot afford deductibles.
Develop relationships and act as a liaison with physicians, patients, infusion centers, manufacturers, and Patient Assistance Programs.
Identify and resolve rejected requests by health plans, including facilitating access to comparable medication regimens; refer to pharmacist in case of potential pharmaceutical alternatives.
Monitor assistance balances for each enrolled patient to ensure funding is available through the completion of therapy (e.g., financial aid).
Communicate medication deductible as applicable.
Maintain continuous communication with the medical office and/or infusion center.
Identify and follow up on refill dates to ensure patients receive medications on time in accordance with the treatment plan.
Other duties: perform or assist with any operation as needed to maintain workflow and meet timelines and quality standards; participate in meetings and working groups prepared by management or colleagues; stay updated on new developments, requirements, and policies.
Escalate any extraordinary situation to the supervisor or manager; availability to attend weekly meetings.
Other duties as assigned by the supervisor.
Minimum Requirements:
Experience in Case Management.
Ability to communicate in English, including reading comprehension, verbal communication, and written communication.
Exemplary communication, customer service, and relationship-building skills with clients; including listening, speaking, and writing in both Spanish and English.
Associate Degree as Pharmacy Technician is required.
Valid Pharmacy Technician license is required.
Specialized training in benefits access and pharmacy/medical requirements is preferred.
EEOC F/M/D/V
Responsabilidades:
Interactúa con los clientes y pacientes saludándolos y ofreciéndoles ayuda con los productos y servicios. Resuelve los problemas de los clientes y responde a sus preguntas para garantizar una experiencia positiva.Registra las compras de los clientes en la caja registradora asignada.Mantiene los mostradores y estantes limpios. Registra y etiqueta los precios de los productos según sea necesario o según lo indique el gerente de la tienda o lo comunique el jefe de turno.Tiene conocimientos sobre los sistemas y equipos de la tienda.Presta servicio al cliente en el área de fotografía, cobro de cheques, gestión de loterías,gestión de programas OTC, UVA, etc.
Ayuda con el mantenimiento exterior e interior, garantizando que la tienda esté limpia y ordenada
y tenga un aspecto impecable.
Requesitos:
Diploma de Escuela Superior y/o 6 meses de experiencia de tiendas al detal preferible.***Patrono con Igualdad de Oportunidades de Empleo M/H/V/I***
Read LessThe Customer Service Associate is the face of Plaza Pharmacy - the person who assists the customer with their needs and provides friendly, courteous, and efficient service to our customers. The Customer Service Associate is also responsible for everything from cash register operations and customer service to assisting in the arrangement of shelves, merchandise, and general store maintenance.
Responsibilities:
• Engages with customers and patients by greeting them and offering help with products and services. Resolves customer issues and answers their questions to ensure a positive experience.
• Provides customers with courteous, friendly, fast, and efficient service.
• Provides customer service in the photo area, cashing checks, lottery handling, OTC programs management, UVA, etc.
• Assists with exterior and interior maintenance ensuring a clean and orderly store condition and appearance.
• Complies with all company policies and procedures; maintains respectful relationships with coworkers.
Required:
• High School diploma.
***Patrono con Igualdad de Oportunidades de Empleo M/H/V/I***
JOB SUMMARY & RESPONSIBILITIES
The Oncology Clinical Associates Management is responsible for performing telephonic and face to face contact with patients of Alivia Specialty Pharmacy. He or she will evaluate the health care and educational needs of the patients regarding medications and will communicate recommendations to prescribers as necessary. Among other duties, the oncology nurse will ensure patient’s understanding of medication regimens and will recognize and provide next steps for patients reporting adverse reactions or concerns with specialty medications.
Responsibilities include but are not limited to:
Assesses, monitors, and evaluates medication care plans, services and outcomes to maximize patient’s health/outcomes. Identifies patient's health and educational needs.Communicates with providers regarding patient's medication complications or needs.Provides guidance to patients on adverse medication reactions within scope and refers to pharmacist as necessary.Completes REMS product training and provides counseling for patients on subsequent cycles of available REMS products.Provides medication counseling for patients starting new medication regimens.Interacts continuously with patient, family, physician(s), and other providers utilizing clinical knowledge and expertise to determine medical history and current status.Reports critical incidents and information regarding quality-of-care issues.Support to LDD team, validates pharmacovigilance protocols and ensure that all team member report correctly and timely all adverse events require by pharmacy and manufacturers for oncology drugs. Serve as education facilitator in new oncology drug including LDD drugs. Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.Participate in extracurriculars activities related to oncology: conventions, in-services, and medical office patient activities.Performs other duties as assigned.REQUIRED PROFESSIONAL EXPERIENCE & PROFESSIONAL COMPETENCIES
Candidate Experience:
2+ years of experience in patient nursing and/or direct patient care is preferred2 years of experience in Specialty Pharmacy is preferredCandidate Skills:
Advanced Demonstrated interpersonal/verbal communication skillsAbility to multi-taskAbility to effectively present information and respond to questions from families, patients, providers, peers and management.Ability to create, review and interpret treatment plansAbility to work as part of a teamDemonstrated time management and priority setting skillsAbility to work independentlyKnowledge and experience in the areas of Neurology /Multiple sclerosis, Hemophilia, Rheumatology, Dermatology, Gastroenterology, Infectious Disease, Asthma, Oncology, or Pediatrics is preferred.Technical Skills:
Knowledge of Microsoft Office programs (Word, Excel, Power Point) is required Knowledge of CPR+ is preferredLanguages:
Ability to communicate effectively in English and Spanish is preferred
REQUIRED EDUCATION, TRAINING & LICENSURE/CERTIFICATIONS
Bachelor’s Degree in Nursing;Oncology Certification or Oncology Master Degree Current/Active Professional Certification/License in PR (in Good Standing)HIPAA, both Security & Privacy; Confidentiality, & Fraud, Waste and Abuse (FWA)JOB SUMMARY & RESPONSIBILITIES
The Oncology Clinical Associates Management is responsible for performing telephonic and face to face contact with patients of Alivia Specialty Pharmacy. He or she will evaluate the health care and educational needs of the patients regarding medications and will communicate recommendations to prescribers as necessary. Among other duties, the oncology nurse will ensure patient’s understanding of medication regimens and will recognize and provide next steps for patients reporting adverse reactions or concerns with specialty medications.
Responsibilities include but are not limited to:
Assesses, monitors, and evaluates medication care plans, services and outcomes to maximize patient’s health/outcomes. Identifies patient's health and educational needs.Communicates with providers regarding patient's medication complications or needs.Provides guidance to patients on adverse medication reactions within scope and refers to pharmacist as necessary.Completes REMS product training and provides counseling for patients on subsequent cycles of available REMS products.Provides medication counseling for patients starting new medication regimens.Interacts continuously with patient, family, physician(s), and other providers utilizing clinical knowledge and expertise to determine medical history and current status.Reports critical incidents and information regarding quality-of-care issues.Support to LDD team, validates pharmacovigilance protocols and ensure that all team member report correctly and timely all adverse events require by pharmacy and manufacturers for oncology drugs. Serve as education facilitator in new oncology drug including LDD drugs. Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.Participate in extracurriculars activities related to oncology: conventions, in-services, and medical office patient activities.Performs other duties as assigned.REQUIRED PROFESSIONAL EXPERIENCE & PROFESSIONAL COMPETENCIES
Candidate Experience:
2+ years of experience in patient nursing and/or direct patient care is preferred2 years of experience in Specialty Pharmacy is preferredCandidate Skills:
Advanced Demonstrated interpersonal/verbal communication skillsAbility to multi-taskAbility to effectively present information and respond to questions from families, patients, providers, peers and management.Ability to create, review and interpret treatment plansAbility to work as part of a teamDemonstrated time management and priority setting skillsAbility to work independentlyKnowledge and experience in the areas of Neurology /Multiple sclerosis, Hemophilia, Rheumatology, Dermatology, Gastroenterology, Infectious Disease, Asthma, Oncology, or Pediatrics is preferred.Technical Skills:
Knowledge of Microsoft Office programs (Word, Excel, Power Point) is required Knowledge of CPR+ is preferredLanguages:
Ability to communicate effectively in English and Spanish is preferred
REQUIRED EDUCATION, TRAINING & LICENSURE/CERTIFICATIONS
Bachelor’s Degree in Nursing;Oncology Certification or Oncology Master Degree Current/Active Professional Certification/License in PR (in Good Standing)HIPAA, both Security & Privacy; Confidentiality, & Fraud, Waste and Abuse (FWA) Read LessThe Commercial Operations Manager role be responsible for providing strategic insight to both the field force and the sales leadership team specific to the business KPI’s, incentive compensation, Sales Force Effectiveness dashboards, field force targeting and management reporting. This role will lead the internal sales support representatives, driving the collaborative alignments among multiple teams, including sales, marketing and operations for Alivia’s Specialty and Infusion. This role will partner with Sales Managers to enable commercial department efficiency, productivity and reporting/analytical capabilities to react quickly to changing customer dynamics and make profitable business decisions. The Commercial Operations Manager applies technical knowledge to solve problems, receives assignments in the form of objectives and determines approach, resources, schedules, and goals. The Sales Manager consistently review performance metrics and promptly identify and address emerging trends, opportunities and issues through specific actions plans by territory and line of business.
Responsibilities include but are not limited to:
Lead Sales Support, and Operations team members in supporting and reducing the administrative burden on the sales force.Craft and present compelling, strategic recommendations for sales team performance to drive new business growth. Drive the creation and implementation of a comprehensive system of dynamic and efficient tools for reporting and analyzing data. Working collaboratively to establish processes that drive continuous improvement and revenue growth.Engage in collaborative dialog with Sales Managers, Operations Managers, Marketing and Finance to create profitable commercial strategies, initiatives, and processes.Analyze performance metrics and sales tool usage reports to identify sales team training needs. Collaborate with our learning and development team to develop strategies to meet these needs.Build strong relationships within a network of colleagues on all levels and ensure effective linkages with all stakeholders. Supports and contributes to a sales Operations vision and strategy aligned with business needs.Works with colleagues to build the infrastructure and capabilities that enable the sales organization to achieve sustainable success.Develop an accessible library of sales processes and programs for quick reference by the organization, using existing technologies as appropriate.Build productive long-term customer relationships with external decision makers. Participate in sales and marketing activities with key customers and/or professional associations. Evaluate and promotes training and continuous education for Commercial TeamTo monitor customer satisfaction and service levels to ensure that standards are being metCandidate Experience:
5years ofprevioussupervisory experience isrequired.Prior experience working in Specialty Pharmacy,Home Infusionorpharmaceuticalsalesisrequired.Demonstratedtrack recordof meeting/exceedinggoals.Demonstrated capability with coaching and developing personnel.Previous experience with coordinating and leading projects***EEOC F/M/V/D***
The Commercial Operations Manager role be responsible for providing strategic insight to both the field force and the sales leadership team specific to the business KPI’s, incentive compensation, Sales Force Effectiveness dashboards, field force targeting and management reporting. This role will lead the internal sales support representatives, driving the collaborative alignments among multiple teams, including sales, marketing and operations for Alivia’s Specialty and Infusion. This role will partner with Sales Managers to enable commercial department efficiency, productivity and reporting/analytical capabilities to react quickly to changing customer dynamics and make profitable business decisions. The Commercial Operations Manager applies technical knowledge to solve problems, receives assignments in the form of objectives and determines approach, resources, schedules, and goals. The Sales Manager consistently review performance metrics and promptly identify and address emerging trends, opportunities and issues through specific actions plans by territory and line of business.
Responsibilities include but are not limited to:
Lead Sales Support, and Operations team members in supporting and reducing the administrative burden on the sales force.Craft and present compelling, strategic recommendations for sales team performance to drive new business growth. Drive the creation and implementation of a comprehensive system of dynamic and efficient tools for reporting and analyzing data. Working collaboratively to establish processes that drive continuous improvement and revenue growth.Engage in collaborative dialog with Sales Managers, Operations Managers, Marketing and Finance to create profitable commercial strategies, initiatives, and processes.Analyze performance metrics and sales tool usage reports to identify sales team training needs. Collaborate with our learning and development team to develop strategies to meet these needs.Build strong relationships within a network of colleagues on all levels and ensure effective linkages with all stakeholders. Supports and contributes to a sales Operations vision and strategy aligned with business needs.Works with colleagues to build the infrastructure and capabilities that enable the sales organization to achieve sustainable success.Develop an accessible library of sales processes and programs for quick reference by the organization, using existing technologies as appropriate.Build productive long-term customer relationships with external decision makers. Participate in sales and marketing activities with key customers and/or professional associations. Evaluate and promotes training and continuous education for Commercial TeamTo monitor customer satisfaction and service levels to ensure that standards are being metCandidate Experience:
5years ofprevioussupervisory experience isrequired.Prior experience working in Specialty Pharmacy,Home Infusionorpharmaceuticalsalesisrequired.Demonstratedtrack recordof meeting/exceedinggoals.Demonstrated capability with coaching and developing personnel.Previous experience with coordinating and leading projects***EEOC F/M/V/D***
The Clinical Programs Supervisor is responsible for performing telephonic and face to face contact with patients of Alivia Specialty Pharmacy. He or she has the responsibility to promote teamwork, give support to supervise daily tasks and complete administrative duties. He or she will evaluate the health care and educational needs of the patients regarding medications and will communicate recommendations to prescribers as necessary. Among other duties, the Clinical Programs Supervisor will ensure patient’s understanding of medication regimens and will recognize and provide next steps for patients reporting adverse reactions or concerns with specialty medications. From time to time, the Clinical Programs Supervisor may be required to conduct some field work to visit HCP’s and Patients or to accompany Management in carrying out some work-related activities.
Responsibilities include but are not limited to:
Assesses,monitorsand evaluates medication care plans,servicesand outcomes to maximizepatient’shealth/outcomes.Identifiespatient'shealth and educational needs.Communicates with providersregardingpatient'smedication complications or needs.Provides guidance to patients on adverse medication reactions withinscopeand refers topharmacistas necessary.Completes REMS product training and provides counseling for patients onsubsequentcycles of available REMS products.Provides medication counseling for patients starting new medication regimens.Interacts continuously withpatient, family, physician(s), and other providersutilizingclinical knowledge andexpertisetodeterminemedical history andcurrent status.Reports critical incidents and informationregardingquality of careissues.Assist Operations/Clinical Department associates with clinical support for prior authorization,billingor other administrative functions, during periods of high volume, tomaintainworkflow and meet customer service imperatives.Provide support ason-call clinician asrequired.Ensurescompliance with all state and federal regulations and guidelines in day-to-day activities.Support ClinicalServices Managerwith the supervision of employees,dutiesand company goals.Performs other duties as assigned.Minimum requirements:
High School Diploma;Bachelor’s Degree in Nursing;3 years of experience in patient nursing and/or direct patient care is preferred2 years of experience in Specialty Pharmacy is preferred*** EEOC F/M/D/V***
Read LessThe Clinical Programs Supervisor is responsible for performing telephonic and face to face contact with patients of Alivia Specialty Pharmacy. He or she has the responsibility to promote teamwork, give support to supervise daily tasks and complete administrative duties. He or she will evaluate the health care and educational needs of the patients regarding medications and will communicate recommendations to prescribers as necessary. Among other duties, the Clinical Programs Supervisor will ensure patient’s understanding of medication regimens and will recognize and provide next steps for patients reporting adverse reactions or concerns with specialty medications. From time to time, the Clinical Programs Supervisor may be required to conduct some field work to visit HCP’s and Patients or to accompany Management in carrying out some work-related activities.
Responsibilities include but are not limited to:
Assesses,monitorsand evaluates medication care plans,servicesand outcomes to maximizepatient’shealth/outcomes.Identifiespatient'shealth and educational needs.Communicates with providersregardingpatient'smedication complications or needs.Provides guidance to patients on adverse medication reactions withinscopeand refers topharmacistas necessary.Completes REMS product training and provides counseling for patients onsubsequentcycles of available REMS products.Provides medication counseling for patients starting new medication regimens.Interacts continuously withpatient, family, physician(s), and other providersutilizingclinical knowledge andexpertisetodeterminemedical history andcurrent status.Reports critical incidents and informationregardingquality of careissues.Assist Operations/Clinical Department associates with clinical support for prior authorization,billingor other administrative functions, during periods of high volume, tomaintainworkflow and meet customer service imperatives.Provide support ason-call clinician asrequired.Ensurescompliance with all state and federal regulations and guidelines in day-to-day activities.Support ClinicalServices Managerwith the supervision of employees,dutiesand company goals.Performs other duties as assigned.Minimum requirements:
High School Diploma;Bachelor’s Degree in Nursing;3 years of experience in patient nursing and/or direct patient care is preferred2 years of experience in Specialty Pharmacy is preferred*** EEOC F/M/D/V***
Read LessJOB SUMMARY & RESPONSIBILITIES
The Business Excellence Client Ambassador serves as 1st layer strategic liaison between internal business excellence teams and external pharmaceutical partners & aggregators to ensure the effective delivery of enhanced pharmacy services to patients. This role focuses on implementation support, driving program success through audit oversight, structured feedback collection, collaboration on continuous improvement initiatives, and client engagement support. The Ambassador plays a key role in translating daily client insights into actionable enhancements while ensuring training and communication initiatives are aligned with service excellence standards and contract compliance. e.
Key Responsibilities:
1. New Contract Readiness and Implementation:
• Ensures contract Redlines, SOP and document creation, Program Training & Educations, Call Scripts.
2. Program Auditing & Performance Monitoring
• Conduct regular audits and ongoing monitoring of program workflows to ensure adherence to service level agreements and contract expectations.Identify performance gaps and proactively escalate for resolution to support sustainable program success.
3. Client Insights & Feedback Collection
• Gather structured client feedback through tools such as surveys, and post-engagement / implementation aluations. Analyze feedback to uncover trends, barrier, and improvement opportunities across program services.
• Translate qualitative insights into meaningful recommendations for operational improvements.
3. Cross Functional Collaboration:
• Participate in non-technical root cause analysis and continuous improvement initiatives to enhance patient and client experience.
4. Training, Enablement & Client Engagement Support
• Provide training on program offerings, communication standards, and pharmacy enhanced services to internal teams.
• Act as a subject matter expert, ensuring the required tools to effectively advocate for both client needs and internal capabilities.
• Coordinate and facilitate client meetings and training sessions, document minutes and track action items.
• Follow up diligently on client-identified pending issues to drive performance outcomes and strengthen partnerships.
REQUIRED PROFESSIONAL EXPERIENCE & PROFESSIONAL COMPETENCIES
• 5+ years of work experience in the health industry (Pharmacy, PBM, or health plan)
or pharmacy technician diploma.
• Excellent monitoring & audit skills
• Outstanding written and oral communication skills in English & Spanish
• Excellent teamwork skills and the ability to engage multiple stakeholders across different initiatives (e.g. functions, Business Units, etc.)
• Self starter comfortable with working in a fast paceddynamic environment with multiple and competing priorities •
REQUIRED EDUCATION, TRAINING & LICENSURE/CERTIFICATIONS
• Pharmacy Technician degree (active License not required)
• Experience in PBM, Pharmacy or Healthcare industry preferred
• Certificate of No Penal record
***EEOC F/M/D/V***
Read Less