PhilRx
Clinical Operations
PatientSupportPharmacySolutionsCoordinator
Neural analysis suggests this role is
optimal for Mid candidates.
“Patient Support Pharmacy Solutions Coordinator at PhilRx. Skills: Patient Support, Pharmacy Solutions, Problem-solving, Communication. Conduct thorough research on order and ticket history to recommend the best resolution that aligns with department guidelines. Ensure all Service Level Agreements (SLAs) are met”
What You'll Achieve.
Optimizing the patient’s experience; Resolve immediate barriers to affordable, timely medication; Improve outcomes for all patients facing similar challenges; Drive long-term patient adherence; Ensure all Service Level Agreements (SLAs) are met; Ensure patient access to therapy
Industry & Context.
Critical thinking; Problem-solver; Resourceful problem-solving; Complex problem-solving; Troubleshoot; Diagnose root causes; Execute a clear resolution pathway
Overtime (OT) and holiday work may be required, Shift Schedule (Pacific Time): Options include 6:00 AM – 3:00 PM, 7:00 AM – 4:00 PM, or 8:00 AM – 5:00 PM
What They're Looking For.
Must Have
Licensed Pharmacy Technician in your state of residence, Minimum 3 years of professional pharmacy technician or prior authorization experience, Proven abilities in complex problem-solving and critical thinking, Highly resourceful, detail-oriented, and capable of seeing complex issues through to completion, Demonstrated adaptability to swift program and process changes, Good general understanding of computers, hardware, networks, and related technology
Nice to Have
Minimum 3 months of tenure with Phil, Consistent history of great attendance, Average performance scores of 95% QA
What You'll Do.
Conduct thorough research on order and ticket history to recommend the best resolution that aligns with department guidelines
Ensure all Service Level Agreements (SLAs) are met
Contact relevant stakeholders to resolve issues that require cross functional collaboration that may impact a successful patient experience
Review and respond to internal escalation requests in a timely and accurate manner
and resolve PAs and appeals via vendor analyze determination trends to provide valuable insights for patient education
Serve as the expert liaison between prescribers
and partner pharmacies
translating technical hurdles into actionable solutions that ensure patient access to therapy
Partner closely with Customer Support to provide clear
jargon-free updates and documentation in our operating systems
ensuring the team has the patient-ready insights needed to support the patient’s journey
Efficiently navigate multiple software systems and vendor portals with a self-starter mindset
maintaining the flexibility to prioritize tasks based on clinical urgency
Investigates complex claim rejections and partners with payers and pharmacies to diagnose root causes and establish and execute a clear resolution pathway that is in accordance with regulatory requirements and manufacturer business rules
Act as the primary technical "fixer" for orders falling outside standard workflows
resolving obstacles such as insurance exceptions
and state-specific shipping regulations
How You'll Work.
Team & Collaboration
Contact relevant stakeholders to resolve issues that require cross functional collaboration; Partner closely with Customer Support; Partner with payers and pharmacies
Communication Scope
Clear communication; Clear, jargon-free updates
Full Job Description
PATIENT SUPPORT PHARMACY SOLUTIONS COORDINATOR This role is a 3 month contract position. Role Summary The Clinical Operations Technician serves as the essential link between our Patient Support Team and the final delivery of prescription services. This role requires not only technical mastery of prescription processing but also the ability to translate complex prescription and order-level hurdles into clear, actionable updates for internal and external stakeholders. Ideal Candidate Profile The ideal candidate demonstrates an uncompromising 100% focus on optimizing the patient’s experience with PhilRx. They are a critical thinker and natural problem-solver, capable of easily and quickly researching and understanding the root cause of an issue. Beyond resolving immediate barriers to affordable, timely medication, our team focuses on long-term strategies to improve outcomes for all patients facing similar challenges. The ideal candidate for this role is a self-starting, results-oriented professional who balances clinical precision with a sense of urgency, utilizing clear communication and resourceful problem-solving to drive long-term patient adherence rather than just completing isolated tasks. Key Responsibilities - Conduct thorough research on order and ticket history to recommend the best resolution that aligns with department guidelines. - Ensure all Service Level Agreements (SLAs) are met. - Contact relevant stakeholders to resolve issues that require cross functional collaboration that may impact a successful patient experience - Build strong internal and external rapport, maintaining positive customer and partner relationships. - Review and respond to internal escalation requests in a timely and accurate manner - Proactively initiate, troubleshoot, and resolve PAs and appeals via vendor portals; analyze determination trends to provide valuable insights for patient education. - Serve as the expert liaison between prescribers, insurance payers, and partner pharma
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