Associate Care Navigator

Role Overview

The Associate Care Navigator is responsible for managing casework on behalf of clients and Southern Scripts to ensure cost savings on specialty drug expenses as per client agreements. This role prioritizes personalized, high-touch member engagement, providing a single point of contact dedicated to managing specialty medications delivery and savings strategies.

Key Responsibilities

• Serve members by explaining components of Southern Scripts’ product offerings, including claims, accumulators, usage, balances, and cost-sharing details.
• Develop, present, and implement member-focused solutions that effectively reduce specialty medication costs while maintaining excellent member experience.
• Ensure referrals are processed timely to meet turnaround targets for specialty drug service provision.
• Adhere to client standards on efficiency, service quality, privacy, and decision-making rigor.
• Maintain compliance with ERISA, HIPAA, and client-specific regulations.
• Collaborate with team members to achieve business unit goals, embracing change and adaptability.
• Engage respectfully and empathetically with a diverse range of stakeholders including medical and pharmacy providers, hospitals, home infusion providers, and vendors within cost-saving initiatives.
• Act with empathy, sound judgment, and discretion to navigate successful specialty medication cost-saving transitions.
• Comply with workplace policies including work rules, HIPAA confidentiality, and reporting any violations promptly.
• Participate in all mandated HIPAA training and demonstrate competency.
• Understand that duties and responsibilities may evolve and additional tasks may be assigned.

Work Hours and Travel

• Full-time hourly (non-exempt) role with core availability required from 8:00 AM to 5:00 PM Central Time.
• Must have flexibility to adjust work hours for meetings across U.S. time zones, with occasional extended hours, weekends, or holidays as industry demands fluctuate.
• Position may necessitate overnight travel from remote locations.

Benefits

• Comprehensive medical, dental, and vision insurance.
• Disability and life insurance coverage.
• Employee Assistance Program (EAP).
• Options for remote work.
• Generous paid time off.
• Annual performance reviews and professional development planning.
• Retirement plan with immediate company match, fully vested.

Required Qualifications

• High school diploma required; some college education preferred or equivalent experience.
• 1-2 years experience engaging members within pharmacy benefit management (PBM) and medical environments.
• 1-2 years of experience specifically with specialty pharmacy or PBM operations.
• 1-2 years of experience using Customer Relationship Management (CRM) platforms.
• Experience collaborating with clinical staff, prior authorization teams, sales, account management, executives, and external clients.

Equal Employment Opportunity

The employer provides equal opportunity employment without discrimination based on race, color, religion, sex, national origin, age, disability, genetics, sexual orientation, gender identity, or veteran status. Workplace harassment is strictly prohibited and may result in disciplinary action, including termination.