CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

We are seeking an experienced Subject Matter Expert (SME) in Specialty Pharmacy Operations to support our internal teams and prospective clients in building, optimizing, and scaling high-performing specialty pharmacy programs. The ideal candidate will have extensive hands-on experience running a specialty pharmacy, deep knowledge of accreditation standards, operational best practices, and strategies to drive financial and clinical performance.

This role will serve as a trusted advisor and educator, helping shape internal product development, go-to-market strategies, and customer engagement models.

Key Responsibilities

Operational Expertise & Education

• Serve as the internal and external expert on all aspects of specialty pharmacy operations.

• Educate internal teams and clients on accreditation requirements, renewals, and compliance best practices (e.g., URAC, ACHC).

• Train teams on core patient management workflows, including:

• Benefits verification and eligibility management

• Prior authorization submission and follow-up

• Financial assistance and copay program navigation

• Patient counseling and ongoing clinical support

​Revenue Cycle & Business Performance

• Provide guidance on revenue cycle management (RCM) processes, including claim submission, denial management, and payment optimization.

• Develop and recommend strategies to improve reimbursement, minimize revenue leakage, and enhance financial outcomes.

• Advise on performance metrics, benchmarking, and reporting frameworks.

340B & Payer Strategy

• Advise on effective 340B capture strategies, contract pharmacy models, and compliance considerations.

• Support payer and manufacturer engagement strategies that align with specialty therapy access and reimbursement goals.

Strategic & Commercial Support

• Collaborate with product management and commercial teams to define differentiated service offerings and value propositions.

• Contribute to the development of go-to-market strategies for new products and services within the specialty pharmacy vertical.

• Participate in client presentations, proposals, and solution design sessions as a trusted subject matter expert.

Qualifications

• Experience: Minimum of 8–10 years of progressive leadership experience in specialty pharmacy operations, preferably in both payer and provider settings.

• Education: Bachelor’s degree in Pharmacy, Healthcare Administration, or related field (PharmD or MBA preferred).

Expertise

• Deep understanding of accreditation standards (URAC, ACHC).

• Proven experience managing patient access programs, benefits verification, prior authorization, and patient support workflows.

• Strong knowledge of revenue cycle management processes and financial performance levers.

• Familiarity with 340B program operations and capture optimization.

Skills

• Excellent communication and presentation skills, with the ability to translate complex operations into actionable insights.

• Collaborative and strategic thinker, capable of influencing internal stakeholders and external clients.

• Proficient with specialty pharmacy management software, workflow tools, data analytics platforms and Salesforce.com.

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.