Clinical Operations Coordinator I - PA Systems

Overview: The Clinical Operations Coordinator I - PA Systems works under the direct supervision the Senior Clinical Operations Manager along with a team of licensed pharmacists. Clinical Operations Coordinator I - PA Systems will assist daily operations of MedOne Clinical Programs and Services.   About MedOne: MedOne is a full-service pharmacy benefit manager (PBM), serving clients and members nationwide. With a fully transparent, pass-through model, MedOne helps people conveniently access the most appropriate prescriptions at the most affordable price.   What You'll Do: Support operations of MedOne Clinical Services Update Clinical Authorization Criteria and Clinical Review Request Forms under the direction of a Clinical Pharmacist Collaborates directly with Clinical Pharmacists to learn and construct time efficient explanations for Prior Authorization determinations Configures clinical criteria requirements and workflows in the Prior Authorization platform for clinical team to utilize Interfaces with Prior Authorization, ePA, and Claims Adjudication vendors and any other technology support vendors to troubleshoot issues arising in platforms relating to system enhancements and optimization. Attends clinical sub-committee meetings, as a non-voting member, to review and complete tasks assigned during meeting relating to system enhancements. Utilizes root cause analysis to determine and improve clinical review processes in order to drive positive outcomes and efficiency within the clinical department Works cross functionally with member advocates and account managers to ensure accurate client information is presented to physicians, clients, and members Supports Data Entry Specialist team as required Supports operations of MedOne Pharmacy Services as needed (applicable to in-office personnel) Assist the Director of Clinical Review, in addition to other MedOne team members with general business operations related to clinical functions Portray the company in a positive image Abide by all rules, regulations, and policies of the employer Other duties as assigned   What You Will Bring to MedOne:

• Must be registered with the state/Iowa Board of Pharmacy as a Pharmacy Technician/Trainee within 30 days of accepting employment (applicable to in-office personnel).
• Working knowledge of medical terminology, HIPAA regulations, ICD-10, NCPDP standards (highly advantageous)
• Must be detail-oriented and precise with data management
• Must have excellent interpersonal, written, and verbal skills
• Strong customer service and teamwork skills
• Must have a strong understanding of Microsoft Office (Word, Excel, PowerPoint)
• Must be able to type at a minimum of 30 words per minute
• Must be able to work independently, meets deadlines, establish priorities, and be flexible
• Must be able to stand/sit for long periods of time within limited space
• Must be able to lift up to 25 pounds
• Working knowledge of date entry services (DES) core functions, with preferred DES experience of 1-2 years.

Why MedOne?   At MedOne, we believe that a healthy team is a happy team. We offer a collaborative work environment, competitive benefits, and opportunities for growth—all while helping to make a difference in people’s lives. Our top core value is to prioritize your well-being.   To support you in living this value, we offer:

• Competitive salary and bonuses that reward your performance.
• Comprehensive health, dental, and vision insurance + additional benefits
• 401(k) with company match to secure your future.
• Generous paid time off and holidays.
• Opportunities for professional growth and development.
• A vibrant and collaborative work culture.

Location: Offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States. Employment Type: Full Time, Hourly Reports to: Director of Clinical Operations   How to Apply: If you're enthusiastic about helping others and eager to join a dynamic team, we’d love to hear from you. Apply now and take the first step toward a rewarding career at MedOne! You can submit your application through our careers page. MedOne is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Job Offers are contingent on passing a background check and drug screen.

Must be registered as a Pharmacy Technician/Trainee with Iowa Board of Pharmacy within 30 days (in-office); working knowledge of medical terminology, HIPAA, ICD-10, NCPDP; Microsoft Office; typing 30 wpm; ability to lift 25 lbs; background check and drug screen.

Key Responsibilities

• supporting clinical operations
• configuring prior authorization workflows
• troubleshooting platform issues

Skills & Tools

Microsoft Word, Microsoft Excel, Microsoft PowerPoint

Job Details

• Category: Healthcare Services - Pharmacy
• Seniority: Entry Level
• Commitment: Full Time
• Workplace: Remote — United States or Dubuque or Kansas City
• Languages: English

Benefits

• 401k matching
• Generous paid time off
• Retirement plan

About MedOne Pharmacy Benefit Solutions

A full-service pharmacy benefit manager with a transparent, pass-through model helping people access prescriptions affordably. — Industry: Healthcare

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