Minnesota Licensed Patient Care Advocate

Serving as a trusted liaison between patients and healthcare providers, the Minnesota Licensed Patient Care Advocate will manage complex pharmacy benefit inquiries, provide education and support, and ensure members receive optimal care in a remote capacity. Key responsibilities: Serve as a subject matter expert on pharmacy and medical benefit structures, interpreting coverage and resolving complex benefit questions Independently assess and resolve authorization and coverage inquiries, providing tailored guidance to members and providers Analyze claims and maintain thorough documentation while identifying trends and recommending process improvements Required qualifications: Bachelor's degree in a healthcare-related field or equivalent experience 4+ years of experience in pharmacy benefits, managed care, or patient advocacy within a healthcare or PBM setting Strong knowledge of pharmacy and medical benefit structures, prior authorization, and appeals processes Excellent communication skills with the ability to convey complex information clearly Proficiency with claims, benefit verification, and case management systems