Clinical Services Specialist
Overview:
Scope of Responsibilities: Assist with the day-to-day operations of the Clinical Pharmacist and clinical department of ProAct. 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 ProAct clients and members.
Responsibilities:
Job Duties:Oversee the prior authorization process to maintain efficiency and timeliness.Review prior authorization requests based on currently-available guidelinesProvide Help Desk support, where appropriate, for questions regarding overrides or system editsResponsible for working with Implementation Department for loading prior authorization data for new clients when appropriateAssist 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 medicationsMaintain records of all prior authorizations completed by ProActProviding reports on monthly basisProviding data for Accounting Department for invoicingAssist in the development and updating of formulary documentsResponsible for completing all mandatory and regulatory training programsAssist with the day-to-day operations of the ProAct Help DeskPerform 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 HigherRequired: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 testInitial and continuous exclusion and sanction/disciplinary monitoringAny and all additional eligibility requirements based on the specific position Job Skills Required:Strong Communication Skills: Must be able to effectively communicate both on the phone and in group setting Strong Organizational SkillsProficient in using Microsoft Excel, Word, and AccessMust be able 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 Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.
Apply Now
Scope of Responsibilities: Assist with the day-to-day operations of the Clinical Pharmacist and clinical department of ProAct. 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 ProAct clients and members.
Responsibilities:
Job Duties:Oversee the prior authorization process to maintain efficiency and timeliness.Review prior authorization requests based on currently-available guidelinesProvide Help Desk support, where appropriate, for questions regarding overrides or system editsResponsible for working with Implementation Department for loading prior authorization data for new clients when appropriateAssist 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 medicationsMaintain records of all prior authorizations completed by ProActProviding reports on monthly basisProviding data for Accounting Department for invoicingAssist in the development and updating of formulary documentsResponsible for completing all mandatory and regulatory training programsAssist with the day-to-day operations of the ProAct Help DeskPerform 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 HigherRequired: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 testInitial and continuous exclusion and sanction/disciplinary monitoringAny and all additional eligibility requirements based on the specific position Job Skills Required:Strong Communication Skills: Must be able to effectively communicate both on the phone and in group setting Strong Organizational SkillsProficient in using Microsoft Excel, Word, and AccessMust be able 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 Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.
Apply Now