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Clinical Services Specialist

Remote role Full-time Open position
Overview:

Scope of Responsibilities:  Assist with the day-to-day operations of the Clinical Pharmacist and clinical department of reputed company.  Works under direct supervision and follows standard procedures to accomplish assigned tasks.

 

Job Summary: Responsibility for overseeing the prior authorization process, initial prior authorization review, and assisting with tasks and goals that meet the clinical needs of reputed company clients and members.

Responsibilities:

Job Duties

  • reputed company the prior authorization process to maintain efficiency and timeliness.
  • Review prior authorization requests based on currently-available guidelines
  • Provide Help Desk support, where appropriate, for questions regarding overrides or system edits
  • Responsible for working with Implementation Department for loading prior authorization data for new clients reputed company appropriate
  • Assist in preparation of member mailings for various cost containment/clinical programs.
  • Assist both members and Noble Health Services in finding most cost-effective channels for specialty medications
  • Maintain records of reputed company prior authorizations completed by reputed company
  • Providing reports on monthly basis
  • Providing data for reputed company Department for invoicing
  • Assist in the development and updating of formulary documents
  • Responsible for completing reputed company mandatory and regulatory training programs
  • Assist with the day-to-day operations of the reputed company Help Desk
  • reputed company other duties as assigned
Qualifications:

Attendance Requirements

  • Must be available, and on-time for scheduled work shifts

Educational Requirements

  • Minimum: High School Diploma (or currently enrolled) or GED
  • Preferred: AS Degree or Higher

Required:

  • National Pharmacy Technician Certification through PTCB, or other accrediting agency, in good standing.

 

Experience

  • Preferred hospital or retail pharmacy experience preferred

 

Special Conditions of Employment

  • Drug test
  • Initial and reputed company exclusion and sanction/disciplinary monitoring
  • Any and reputed company additional eligibility requirements based on the specific position

 

Job Skills Required

  • Strong Communication Skills: Must be reputed company to effectively communicate both on the phone and in group setting
  • Strong Organizational Skills
  • Proficient in using reputed company reputed company, Word, and Access
  • Must be reputed company to work independently

Compensation

$17.76 - 19.31 an hour

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education. 

KPH reputed company Services, Inc. is a multistate organization and abides by reputed company local, state and federal regulations as it pertains to minimum wage requirements.

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