Patient Outcomes and Initiatives Specialist

Join us in improving health care outcomes for all!  We promise to do what’s right, always.

Position Summary:

The Patient Outcomes & Initiatives Specialist is part of a fast-moving, cross-functional team focused on advancing strategic initiatives that enhance patient care while managing costs. This role combines compassionate member advocacy with data-driven project work, such as outbound engagement, benefit optimization, and formulary transitions. The Specialist helps members navigate their pharmacy benefits and connects them with affordable care solutions in a clear and empathetic manner. Ideal candidates have experience in strategic outreach, member engagement, or healthcare communications, along with strong communication skills and an analytical mindset. Success in this role requires adaptability and the ability to thrive in a dynamic, mission-driven environment.

What you will do:

Strategic Member Engagement:

• Conduct proactive outreach to members via phone, email, or text to educate them on lower-cost medication options, preferred pharmacy locations, and benefit or formulary changes
• Assist members and prescribers in understanding covered alternatives and guide them through benefit transitions smoothly
• Translate complex pharmacy benefit information into clear, accessible guidance to support informed decision-making
• Advocate for members with empathy, ensuring personalized support that prioritizes affordability and clarity

Special Projects and Client Initiatives:

• Participate in targeted client and internal initiatives, including benefit change rollouts, member education campaigns, cost-containment programs, and custom reporting
• Support the planning, execution, and tracking of assigned initiatives with a focus on timely follow-up and clear documentation
• Assist with ad hoc client requests by delivering accurate information and responsive support
• Contribute to the Benefit Requirements Document migration project by validating, formatting, and transferring benefit data with attention to accuracy and efficiency

Collaboration and Reporting:

• Serve as a liaison between members, pharmacies, providers, and internal stakeholders to ensure coordinated support
• Collaborate cross-functionally with Operations, Clinical, and Client Services teams to ensure seamless execution of shared goals and initiatives
• Assist in developing and maintaining reports and dashboards to track engagement, performance and outcomes
• Monitor member feedback and inquiry, provide insights to improve future initiatives and communication strategies

 Knowledge and Continuous Improvement:

• Stay current on pharmacy benefit design, formularies, and utilization management practices
• Maintain knowledge of copay assistance programs, affordability resources, and healthcare regulations
• Monitor PBM policies and industry trends to inform best practices and support member needs
• Proactively identify process improvements and solutions to enhance the member experience and reduce barriers to care

 What you need:

• Bachelor’s degree in healthcare, communications, business, or a related field preferred; equivalent experience will be considered
• Minimum of 2 years’ experience in healthcare, pharmacy benefits, customer service, or patient advocacy
• Prior experience working in a fast-paced, project-driven, or cross-functional team environment is preferred
• Excellent verbal and written communication skills, with the ability to convey complex information in a clear, approachable manner
• Comfortable discussing sensitive topics with members, including medication costs, benefit changes, and coverage limitations
• Strong analytical thinking with the ability to interpret data and identify trends or opportunities for improvement
• Familiarity with pharmacy benefit design, formularies, and cost-containment strategies is a plus

What you get:

• To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes
• To work in a culture where people thrive because when OUR team thrives, OUR business thrives
• Competitive compensation, including health, dental, vision and other benefits

Note: 

AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.