Clinical Operations Specialist

Job overview

The Clinical Operations Specialist role is an onsite, full-time position in Orlando, FL. Compensation is not specified. EmpiRx Health is a clinically driven pharmacy benefits management company focused on pharmacy care, health outcomes, and prescription spending. The specialist provides administrative and operational support to adjudication, prior authorization, and clinical review teams. The role helps ensure accurate, timely case processing and documentation, supporting service quality, compliance, and coordination among clinical and operational teams.

What you'll do

• Provide administrative and operational support to adjudication, prior authorization, and clinical review teams
• process claim overrides and case documentation according to SOPs
• meet turnaround times and quality metrics
• assist with workflow management and reporting
• monitor case queues and follow up to meet case targets and the two-hour SLA for escalation requests
• escalate complex or high-priority issues
• collaborate with pharmacists, call center representatives, Member Services, Client Management, and internal stakeholders
• identify opportunities to streamline administrative procedures.

What we're looking for

Skills & competencies

clinical operations specialist

orlando fl

empirx health

full-time

pharmacy benefits management

prior authorizations

claims overrides

clinical review

case documentation

two-hour sla

workflow support

member services

client management

pharmacy care

Work arrangement

• Weekend coverage required

Why this role

The role supports a newly launched AI-powered pharmacy care platform and requires adherence to a two-hour SLA for escalation requests.

About the employer

EmpiRx Health, LLC is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.