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Prescription Experience Specialist

πŸ“… Aug 27
Prior AuthorizationsCase ManagementHealthcare OperationsInsurance Plans
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πŸ“œ Description

  • Manage prescriptions for newly onboarded practices and escalated cases from first submission through final determination.
  • Navigate prior authorizations across insurance plans, pharmacies, and affordability programs.
  • Investigate stalled cases, coordinate with internal teams, and follow through until resolved.
  • Proactively identify and resolve issues with plans, pharmacies, and providers before they cause delays.
  • Communicate with providers and patients by phone, email, and text, including de-escalating high-stress situations.
  • Identify prescription patterns, maintain case accuracy, and optimize operational workflows.

πŸ› οΈ Requirements

  • Experience with analytical problem-solving, operational rigor, and ownership of outcomes.
  • Client-facing communication experience across phone, email, and text.
  • Medical or healthcare background is a plus.
  • Ability to manage and prioritize a varied caseload independently.
  • Ability to learn complex software quickly and work with data.
  • Ability to resolve ambiguous problems and adapt to changing workflows.
Full job description

This is a remote full-time hourly role, 9am-5pm (Pacific Time)/12pm-8pm (Eastern), including Saturdays. We are currently able to employ team members who live in: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin. If you do not currently reside in or are actively relocating to one of these states, we unfortunately cannot consider your application at this time.

About the role

Generator Health exists to make sure administrative friction never stands in the way of a patient getting the medication they need. The Prescription Experience Specialist sits inside that mission on two fronts: you'll personally own a portfolio of newly onboarded provider practices and shepherd their very first prescriptions through prior authorization and you'll serve as the escalation-tier point of accountability when any case has moved beyond first-tier support and needs someone to see it through to resolution.

A new practice's experience with us matters enormously, it's when they decide whether to trust us with their full patient volume. Your job is to make that first month feel effortless: catching errors before they become delays, proactively solving problems the practice doesn't even know exist yet, and being the single point of accountability for how their scripts move through our system. When a case, whether from a newly onboarded practice or escalated from first-tier support, has stalled or fallen through the cracks, you investigate its full history, loop in the right internal teams, and drive it to a clean resolution.

This is a role that requires quickly learning complex, real-world operational processes: how prior authorizations actually move through insurance plans, pharmacies, and internal systems then applying that knowledge under time pressure, case by case.

If you join, you will

  • Own the end-to-end prescription experience for a portfolio of newly onboarded practices and escalated cases, from first submission through final determination

  • Become an expert in navigating prior authorizations across insurance plans, pharmacies, and affordability programs to get prescriptions processed quickly and correctly

  • Operate in a case-management style: investigate the full history of a case, identify where something has stalled, loop in and escalate to the right internal teams, and follow through until it's resolved

  • Proactively catch and resolve issues before they become delays, working directly with plans, pharmacies, and providers as needed

  • Communicate with providers and patients across phone, email, and text, bringing expert-level knowledge of our systems so every interaction reflects a 5-star experience

  • De-escalate high-stress situations β€” providers and patients should leave feeling heard, understood, and confident their issue is in capable hands

  • Maintain a high level of accuracy in every case; given the stakes involved, the expectation is 100% accuracy

  • Spot patterns across a practice's prescriptions and turn them into practical guidance for the practice or an escalation for internal teams

  • Master proprietary software tools to execute operational workflows efficiently while continuously adapting and optimizing processes

  • Build the judgment to know when to intervene, when to escalate, and when to let a case run its course

  • Collaborate cross-functionally, coordinating with other teams whenever a patient or provider issue requires it

We'll be most excited if you

  • Have experience in a role that required analytical problem-solving, operational rigor, and real ownership of outcomes, not just completion of assigned tasks

  • Have client-facing experience and are as comfortable on the phone as you are on text or email, and would rather pick up the phone to resolve something than wait for it to resolve itself

  • Know how to de-escalate a tense conversation and leave someone feeling genuinely taken care of, not just β€œhandled”

  • Bring some degree of medical or healthcare background (medical assistant, pre-med, healthcare support experience, or similar) β€” this provides a real head start on the prescription and insurance lifecycle

  • Can hold a growing, varied caseload in your head at once and prioritize your own queue without being told what to do next

  • Are able to master new, complex software tools quickly and are comfortable working with data

  • Know how to work through ambiguous problems and drive them to resolution, and can adapt quickly to new workflows and understand how a change upstream affects the patient or provider downstream

Growth path

This is a new, closely tracked function. Strong performers have a defined path to grow into Customer Success roles as the program scales.

As this program matures and we finalize how individual performance is measured, we expect compensation structure for this role to evolve, potentially including a performance-based component.

Our salary ranges are based on a number of factors, including qualifications, experience level, and geography.

Generator Health is an equal opportunity employer and does not discriminate on the basis of race, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition, or any other basis protected by law.

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