Patient Care Advocate - WA/OR Licensed

Job Summary

To support patient care in Washington and Oregon, the remote Patient Care Advocate - WA/OR Licensed will serve as a liaison between patients and healthcare providers, utilizing expertise in pharmacy benefits to resolve complex issues and ensure members receive optimal care and support.

Key responsibilities:

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

Required qualifications:

• Must reside in Washington or Oregon
• Bachelor's degree in a healthcare-related field or equivalent experience
• 4+ years of experience in pharmacy benefits, managed care, or patient advocacy
• Strong knowledge of healthcare regulations, prior authorization, and payer processes
• Proficiency with claims, benefit verification, and case management systems