What are the responsibilities and job description for the Clinical Review Technician position at MedOne Pharmacy Benefit Solutions?
Position Overview:
The Clinical Review Technician works under the supervision of the licensed pharmacist on duty during day-to-day operations and reports directly to the Clinical Review Technician Supervisor. The Clinical Review Technician will perform clinical functions in supporting the daily operations of MedOne Clinical 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 Will Do at MedOne:
Support operations of MedOne Clinical Services
Conduct clinical assessments to evaluate the appropriateness of medication therapy as part of the clinical review/prior authorization process
Communicate clinical review decision to pharmacies and providers
Maintain quality and productivity standards for all cases reviewed while meeting established turnaround time requirements
Complete Proactive Prescriber Outreach Program (PPOP) calls and requests as assigned
Provide mentorship to the Data Entry Specialist team as required
Assist Member Advocate and Account Management teams with patient or provider requests not requiring pharmacist intervention
Works to promote a team environment
Support the operation and maintenance of existing MedOne Clinical Service
Assists and supports members of MedOne Pharmacy Benefit Solutions
Portrays the company in a positive image
Required to abide by all rules, regulations and policies of the employer
Other duties as assigned
What you will bring to MedOne:
CPhT certification, or state equivalent at date of hire
High school diploma or equivalent (Associate’s or Bachelor’s degree preferred)
1–3 years of experience in healthcare, pharmacy, insurance, or prior authorization support
Detail-oriented with a high degree of accuracy
Strong interpersonal, written, and verbal communication skills
Ability to work independently and manage time effectively
Excellent customer service and teamwork skills
Must have a designated workplace (an office, spare bedroom, etc.) that is visibly secure from others during work hours (closed door) and is protected from noise that could disrupt conversations (for remote employees)
Must have a strong understanding of Microsoft Office (Word, Excel, PowerPoint)
Familiarity with data entry software or CRM systems (Microsoft Dynamics) is a plus
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
Must be able to work cooperatively with MedOne staff
Why Join MedOne?
Competitive salary and bonuses that reward your performance
Comprehensive health, dental, and vision insurance
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: We have offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States
Employment Type: Full-Time, Hourly/Non-Exempt
Hours: Hours may vary within our normal business hours