[Remote] Care Operations Associate at Abarca Health

Remote

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Mental Health, EdTechIndustries

Requirements

High school diploma or equivalent; Associate's or Bachelor's degree in healthcare administration, business, or a related field preferred
1-3 years of experience in a customer service role, preferably within a healthcare setting
Strong understanding of healthcare operations, terminology, and common practices
Strong problem-solving skills and precise attention to detail
Excellent verbal and written communication skills with the ability to explain complex information clearly and concisely; comfort on the phone as an external representative of Mantra
Demonstrated experience with owning a process end-to-end, troubleshooting issues beyond simple scripted solutions, and proactively suggesting process improvements based on observed pain points
Compassion, patience, and a genuine desire to help others
Proven ability to work within operational metrics and familiarity with KPIs in healthcare or operations settings
Ability to maintain confidentiality and adhere to all HIPAA guidelines
Ability to work effectively in a fast-paced environment and manage multiple tasks simultaneously
Metrics-driven mindset with demonstrated ability to meet or exceed operational KPIs while maintaining quality and accuracy standards
Ability to foster a collaborative team environment, particularly during high-pressure situations, by communicating clearly

Responsibilities

Serve as the primary point of contact for administrative care support inquiries via phone, email, and chat, providing accurate, policy-aligned responses and ensuring compliance with all privacy and documentation standards
Assist students with navigating online portals, activating care, scheduling appointments, and supporting their continuity of care process
Collaborate with clinical providers, technical support, partner success, and other internal teams to resolve complex issues and ensure seamless patient care
Document all interactions and resolutions thoroughly and accurately in the customer relationship management (CRM) system and electronic health record (EHR)
Identify and escalate urgent or sensitive issues to appropriate personnel for immediate resolution
Contribute to the development and continuous improvement of care operations workflows, standard operating procedures (SOPs), and training resources
Handle complaints and concerns with sensitivity and professionalism, striving for positive outcomes
Participate in training sessions and team meetings to enhance knowledge and skills

Skills

Customer Support

Healthcare Operations

Communication Skills

Troubleshooting

Appointment Scheduling

Privacy Compliance

Online Portal Navigation

Chat Support

Email Support

Phone Support

Abarca Health

Pharmacy Benefit Management services provider

About Abarca Health

Abarca Health provides Pharmacy Benefit Management (PBM) services, focusing on flexible and user-friendly solutions for health plans, employers, and government programs like Medicare and Medicaid. Its main product, the Darwin platform, allows clients to quickly implement and modify benefit designs while ensuring compliance with regulations. Abarca Health manages over $5.3 billion in drug spend and processes 100 million prescription claims annually, offering additional services like home delivery for prescriptions. The company's goal is to deliver exceptional service and innovative solutions in the PBM market.

Aventura, FloridaHeadquarters

2005Year Founded

VENTURE_UNKNOWNCompany Stage

HealthcareIndustries

501-1,000Employees

Benefits

PTO

Parental leave

Work flexibility

Health insurance

Wellness stipend

401k

Tuition reimbursement

Leadership development programs

Risks

Increased competition from Amazon Pharmacy and Mark Cuban's Cost Plus Drug Company.

Growing focus on specialty drugs may require platform adaptation.

Shift towards price transparency could pressure Abarca's pricing models.

Differentiation

Abarca Health's Darwin platform is highly adaptable and user-friendly.

The company offers innovative programs like Triple S en Casa for home delivery.

Abarca Health ensures compliance with ever-changing healthcare regulations.

Upsides

Abarca transitioned two million members to Darwin in 18 months, showing operational efficiency.

Collaboration with Blue Shield of California boosts Abarca's reputation in the PBM sector.

Recognition as a top IT workplace attracts top talent, driving innovation.

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