Full Time
Job Description:
Fully remote pharmacy programs specialist at Clover Health supporting Part D quality metrics and member/provider phone outreach. About 3 years of pharmacy or managed-care experience preferred. Pays $53,800 to $70,000. Bilingual Spanish preferred.
About the Role
Clover Health is hiring a remote Pharmacy Programs Specialist on its Clinical Pharmacy team to validate claim adjudication, support telephonic outreach for members and providers, and help improve Medicare Part D Star measures.
What You Will Do
- Create, manage, and respond to cases and escalate to Clinical Pharmacists as needed
- Support Part D Star measures by resolving medication management root causes
- Serve as liaison to the PBM account team and escalate vendor questions
- Document activity in electronic medical records and maintain quality standards
- Lead training and knowledge-base updates for Part D workflows as assigned
What You Need
- At least 3 years working in pharmacy, managed care, a medical office, or a hospital setting
- National Certification (CPhT) Pharmacy Technician License preferred
- Fluent English and Spanish (oral and written) preferred
- Understanding of managed care and Windows PC applications
- Ability to work Eastern Time hours; ET candidates preferred
Location & Pay
Remote-first in the United States. Eastern Time hours preferred. Base salary range $53,800 to $70,000 plus equity opportunities, bonus program, and benefits. Posted about 2026-09-17.