- Where
- Makati City, Philippines
- Level
- Mid
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.