Minnesota Licensed Patient Care Advocate

Job Summary

Serving as a trusted liaison between patients and healthcare providers, the Minnesota Licensed Patient Care Advocate will manage complex pharmacy benefit inquiries, provide education and support, and ensure members receive optimal care in a remote capacity.

Key responsibilities:

• Serve as a subject matter expert on pharmacy and medical benefit structures, interpreting coverage and resolving complex benefit questions
• Independently assess and resolve authorization and coverage inquiries, providing tailored guidance to members and providers
• Analyze claims and maintain thorough documentation while identifying trends and recommending process improvements

Required qualifications:

• Bachelor's degree in a healthcare-related field or equivalent experience
• 4+ years of experience in pharmacy benefits, managed care, or patient advocacy within a healthcare or PBM setting
• Strong knowledge of pharmacy and medical benefit structures, prior authorization, and appeals processes
• Excellent communication skills with the ability to convey complex information clearly
• Proficiency with claims, benefit verification, and case management systems