Company Bio:

Founded by industry pioneers, SlateRx provides simple and affordable pharmacy benefit programs to employer groups, unions, public sector groups, health systems, and other payers throughout the United States. As the industry’s only PBXTM, SlateRx is creating real value for plan sponsors on day one through purchasing scale and continued management via innovation and transparency. Our model is designed to improve an out-of-touch healthcare model to make pharmacy benefits simple and affordable for plan sponsors and members.

Job Overview:

The Clinical Coordinator Team Lead serves as an advanced-level resource within the Clinical Operations department. The Team Lead provides day-to-day workflow support, ensures operational efficiency, and serves as a key contact for escalation and procedural clarification.

This position supports both leadership and coordinators by ensuring smooth execution of the coverage determination and appeals processes, maintaining compliance standards, and promoting accuracy and timeliness of work. The Team Lead actively participates in daily processing of cases while monitoring team queues and performance metrics.

This role does not have supervisory authority and does not approve timecards, conduct performance reviews, or mentoring/coaching activities.

Responsibilities:

As a Clinical Coordinator Team Lead, your key responsibilities will include:

• Serve as the first point of contact for escalations or complex cases; collaborate with Supervisor to resolve issues efficiently.
• Review cases for accuracy, completeness, and compliance providing QA support.
• Research claim reject messaging and system-related issues to support accurate processing.
• Assist in maintaining and updating workflow documentation and standard operating procedures.
• Communicate updates on procedural changes, system issues, or workflow modifications.
• Respond to inquiries from prescribers, members, pharmacies, and internal departments providing guidance to frontline staff.
• Identify workflow or process gaps and escalate to the Clinical Operations leadership for resolution.
• Recommend process improvements to increase efficiency and quality.
• Perform miscellaneous duties or project work assigned by leadership.

Qualifications:

To excel in this role, you should possess the following qualifications:

• Knowledge of pharmacy benefit management, CDAG operational processes, and applicable regulatory requirements.
• Proficient in data entry, documentation, and system navigation.
• Capable of interpreting complex case data and supporting resolution.
• Ability to adapt to a dynamic and fast-paced environment.
• Possess strong organizational, analytical, and communication skills.
• Ability to work independently and manage multiple priorities.
• Capability to efficiently complete tasks in a demanding environment.

Education:

High school diploma or GED required; Bachelor’s degree strongly preferred.

License Requirement:

Current and valid Pharmacy Technician Certification, Licensure, or Registration; OR a minimum of 4 years’ experience with appropriate industry experience, preferably in pharmacy benefit management, healthcare, or insurance environment.

Job Benefits:

Health, Dental, Vision, Life, 401k, Paid Time Off.

Location:

Remote