Overview
The primary focus of the Clinical Case Management Analyst is to support Clinical Analytics by managing the operational requirements of clinical case management and disease state management. This includes analyzing pertinent clinical data points and providing clear and concise professional follow-up to the associated parties. This position also includes gathering and analyzing data in support of proposed projects and requirements.
Position Location
This is a remote-based position within the Continental US.
Our Company
Founded in 1926, Maxor is a leading, independent pharmacy solutions platform that improves prescription drug affordability and outcomes. Over time, Maxor has built a unique and complementary suite of services and technology offerings that deliver clinical, financial and strategic value to patients, payors and providers across the pharmacy supply chain. Maxor has a proud heritage of growth and innovation earned over the decades. Amarillo, Texas is the legacy headquarters for Maxor, but our talent base is national. We operate pharmacies and other business operation sites across the United States with more than 1100 employees working from 42 states.
Why Maxor?
Pharmacies are essential to healthcare, with nearly 90% of the US population living within 5 miles of one and seeing their pharmacist an average of 12 times a year. Providing a positive patient experience is crucial to ensuring patients adhere to their therapies. At Maxor, we recognize that our employees are our most valuable assets. We actively seek and retain talented professionals who are mission-driven to improve healthcare outcomes for patients. Our employees are essential to their own well-being, finding fulfillment in meaningful work, competitive compensation, diverse and inclusive teams, and limitless career possibilities. With a workforce of 1,000+ and almost a century of pharmacy experience, we offer the stability of a Fortune 500 company and the energy and innovation of a startup. Our expertise and technology support the entire pharmacy ecosystem, but our impact goes beyond pharmacy services. We enable pharmacy care.
Responsibilities
- Complete provider and/or member outreach as it pertains to and is necessary for clinical case management and disease state management.
- Manage queue of work tasks daily while providing required case documentation
- Documents / maintains case assessments, reassessments and care management plans in the electronic patient management program, e.g., Access, internal clinical platforms.
- Assess, plan, create, and implement patient care plans while consulting with healthcare professionals.
- Assist members with navigating thought healthcare system
- Prepare detailed reports when required.
- Work with Clinical Analytics staff in developing and carrying out various clinical initiatives.
- Generate and review standard monthly and quarterly reports, as required.
- Attend and participate in other programs, committees, meetings, and functions as required.
- Work cooperatively with other staff members to enhance the team concept.
- Maintain regular attendance in accordance with established policies and procedures.
- Perform other job-related duties as assigned.
- Promptly report any allegations of impropriety to the Compliance Department.
Qualifications
Education:
- Active certified pharmacy technician license in the state of employment preferred
- Bachelor's degree in relevant healthcare field preferred
Experience:
- 2+ years in healthcare industry (Pharmacy Benefit Management, Managed Care, Health Plan, and/or Clinical Casees
- 2+ years working with pharmacy data management systems, medication therapy or disease management, case management, and/or medical data analytics
Knowledge, Skills and Abilities:
- Ability in organizing, prioritizing, and scheduling work assignments.
- Ability to manage multiple, complex, concurrent projects.
- Ability to communicate effectively, both verbally and in writing, with professional staff and the public.
- Ability to develop and maintain recordkeeping systems and procedures.
- Skill in examining and re-engineering clinical operations and procedures, implementing policy, and developing and implementing new strategies and procedures.
- Proficient in Microsoft Office Suite, including Word, PowerPoint, and Visio.
- Proficient in database management, including Access
- Advanced proficiency in Microsoft Excel is preferred
- Team-oriented with experience contributing to high-performing teams, while also capable of working independently and self-learning when required
WE OFFER
At Maxor, we foster a diverse and progressive culture that promotes a work-from-home model and a "dress-for-your-day" approach to work attire. Our team-oriented environment encourages collaboration and innovation.
We offer highly competitive compensation and comprehensive health benefits including:
- Comprehensive mental health and wellbeing resources
- Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
- Company-paid basic life/AD&D, short-term and long-term disability insurance
- Rx, dental, vision, other voluntary benefits, and FSA
- Employer-matched 401k Plan
- Industry-leading PTO plan
- And more!
Apply today at: https://www.maxor.com/careers/
Maxor is an EOE, including disability/vets
