Pharmacy Care Manager

Pharmacy Care Manager

Remote – Equipment provided (must have hard‑wired connection, not Wi‑Fi compatible)

Schedule:

M‑F 8am‑8pm EST (Standard business hours; overtime or campaign support may be requested during peak periods)

Pay: $21/hr

Anticipated

Start Date:

2/17

Contract:

3‑Month Contract

• Make outbound PBM/payor calls for copay eligibility throughout the workday; maintain phone engagement up to 95% of the shift while executing the correct outbound campaigns and dispositions.
• Follow approved Call Guides to ask structured, plan‑identifying questions of PBM agents; use compliant script/verbiage and payor‑call steps.
• Determine and record the verified plan type:
  Traditional, Accumulator, Hybrid Accumulator, Maximizer, or Hybrid Maximizer, etc. using program definitions and SOPs.
• Use PBM‑specific prompts (e.g., BIN/PCN/Group workflows, NPI handling, maximizer screening questions) to obtain the benefit details needed for eligibility determination.
• Document every interaction accurately and in real time: complete call guide fields, outcomes, and notes in the designated CRM/telephony tools before taking/making the next call.
• Create and manage follow‑up activities/tasks as needed with timely completion.
• Maintain availability/status discipline in the telephony platform (Available/Ready, appropriate Away Codes, correct outbound campaign selection) to maximize connect time.
• Adhere to program compliance and quality standards (privacy, script adherence, recorded‑call protocols) and participate in QA monitoring.
• Collaborate professionally with payor/PBM contacts and internal teams; route inquiries outside program scope through approved channels.

• Phone time/adherence (targeting up to 95% outbound activity).
• Call guide adherence and QA scores; correct plan‑type identification per program definitions.
• Documentation completeness and timeliness; follow‑up task creation and completion rate.

This is a remote, phone‑based, payor/PBM‑facing role conducted on recorded lines. Copay Business hours are 8am to 8pm EST. However, candidates in this role may be assigned Standard business hours with shift assignments; overtime or campaign support may be requested during peak periods.

• High School Diploma or equivalent; some college preferred.
• Minimum 2 years experience in pharmacy benefits.
• Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc.) and soft phone systems (Web Ex, Mitel, Shoretel, etc.).
• Exceptional communication skills, both written and verbal.
• Ability to work in a virtual team environment by being available and responsive during working hours.
• Remote position: employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines. Workspace must include internet plug‑in accessibility. Wi‑Fi connectivity is not permitted.
• A working cell phone is required for 2‑step authentication verifications during the length of the assignment.

• Medical, dental & vision.
• Critical Illness, Accident, and Hospital.
• 401(k) Retirement Plan – Pre‑tax and Roth post‑tax contributions available.
• Life Insurance (Voluntary Life & AD&D for the employee and dependents).
• Short‑and long‑term disability.
• Health Spending Account (HSA).Transportation benefits.
• Employee Assistance Program.
• Time Off/Leave (PTO, vacation, or sick leave).

Fully remote.

This position is anticipated to close on Jan 23, 2026.

Contract position based out of Durham, NC.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.