Clinical Administrator

Clinical Administrator

Specializes in workers compensation pharmacy management with a strong focus on patient advocacy. Combines clinical expertise and advanced analytics to streamline claims management and promote safer, more effective medication therapy management.

Job Overview:

Responsible for supporting clinical operations by reviewing and validating case information, maintaining thorough documentation, coordinating outreach with prescriber offices, preparing and distributing clinical correspondence, and facilitating communication between prescribers and Clinical Pharmacists to ensure timely case resolution.
 

Roles and Responsibilities:

• · Receives and acts on system-generated alerts and workflow triggers.
• · Reviews member, medication, and case information for accuracy and completeness.
• · Maintains detailed and audit-ready case documentation.
• · Conducts follow-ups with prescribers via calls, fax, and email.
• · Prepares and distributes required clinical and administrative documents.
• · Coordinates communication between prescribers and pharmacists.
• · Monitors pending cases and follows up on outstanding requests.
• · Collaborates with internal stakeholders to ensure timely case progression.

Qualifications:

• Bachelor’s degree required
• At least one year U.S. healthcare experience
• Proficiency with Microsoft Office tools and data-entry systems
• Capable of conducting outbound calls and effectively communicating with provider offices
• Comfortable with electronic communication such as email and MS Teams
• Familiarity with case management, documentation, and compliance standards.
• Experience in PBM, managed care, healthcare, or workers compensation is an advantage.
• Strong attention to detail and accuracy in case processing.
• Capable of managing multiple priorities and meet deadlines.
• Ability to work independently, exercise sound judgment, and seek guidance when needed.
• Amenable to work on shifting schedule during U.S. business hours
• Willing to work onsite at the Makati Office.

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All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, or any other characteristic protected by law.

Genfinity as an Equal Opportunity Employer, believes in each person’s potential, and we’ll help you achieve yours.

All information will be kept confidential according to EEO guidelines.

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