Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.  

Who Are We? ✨ 

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. 

Why Join Us? 🏆

We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. 

Job Summary

 The Pharmacy Specialist (internally known as Medication Adherence Specialist) will help members understand their medication adherence by providing education, reminders and support while assisting the Director with pharmacy operations. This position will interface with members and network pharmacies, working to help improve medication adherence issues, and working in partnership with the Director of Pharmacy to answer and assist member inquiries.

Functions & Job Responsibilities

• Be a resource for internal associates for Clever Care Pharmacy Benefits, formulary, all pharmacy-related processes and plan benefit design.
• Educate members and prospective members regarding all Pharmacy-related benefit inquires.
• Educates and contacts members or caregivers about medication refills that are upcoming or overdue
• Assist members with refills with our network pharmacies when necessary
• Direct any clinical concerns and issues to pharmacy leadership when they arise.
• Work in tandem with Stars/HEDIS team to raise and maintain high medication adherence rates
• Participates in member calling projects as assigned by management to support the overall Clever Care goal of membership service
• In-person physical presence at Clever Care’s community centers to be a resource for our members.
• Follows policies and procedures and job aids in order to maintain efficient and complaint operations; communicates suggestions for improvement and efficiencies to management; identifies and reports problems with workflows following proper departmental procedures; actively participates in departmental staff meetings and training sessions
• Follows all appropriate Federal and State regulatory requirements and guidelines applicable to Clever Care Health Plan operations, as documented I company policies and procedures. Follows all HIPAA requirements
• Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals
• Ability to work in an environment where continuous coaching and feedback is the standard practice.
• Other duties as assigned

Qualifications

Education and Experience

• High School Diploma or equivalent required
• Bachelor’s Degree or equivalent work experience preferred 
• Two (2) years experience as a certified pharmacy technician preferred
  • If active pharmacy technician, active License as a Pharmacy Technician required (CPhT) in California
  • Experience working in a retail pharmacy highly preferred
• If not pharmacy technician, two (2) years experience in a doctor’s office, clinic, health plan, or other member-facing healthcare setting required

Skills

• Very strong knowledge of all Pharmacy-related benefits is required
• Exceptional customer service skills, including verbal and written communication
• Strong active listening skills
• Ability to collaborate and be a team player
• Must be a quick learner and willing to ask questions for clarifications/additional information
• Professional and effective time management skills, attendance, and organization of all documents and information
• Bilingual in English and either Korean, Vietnamese, Mandarin, or Cantonese
• Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations 
• Proficient knowledge of retail pharmacy workflow and claims adjudication
• Understanding of health plan formularies, prior authorizations, etc.

Wage Range: $20.00/hour - $31.00/hour

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

• Must be able to travel when needed or required  
• Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
• Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.

Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly.

Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. May occasionally be required to work irregular hours based on the needs of the business.

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency.