A7 Recruitment Corporation
Certificate is a must-have. Provide technical and administrative support to the Fee-For-Service (FFS) Medicaid department, primarily by working directly with the client teams, Clinical Account Executives (CAEs), Clinical Specialists, and Clinical PA Guidelines/Drug Information Management staff to create and support the appropriate administration of pharmacy information to include Medication Request Guidelines, Medication Request Forms (MRFs), and electronic rules. Support PA in researching PA-related tasks, PA Implementation and perform Prior Authorization processing as needed. Essential Duties and Responsibilities: Create and maintain PA Guidelines documents (content management, file maintenance and archiving, coding and linking in on-line electronic systems). Provide technical and administrative support to the Clinical Program Manager, Clinical PA Guidelines, Drug Information and PA&UM staffs with the Medication Request process to include formatting, verifying and testing of client Medication Request Guidelines (custom and standard) and formatting/development of Medication Request Forms (MRFs) and electronic rules. Communicate with clients to obtain client authorization of final documents and ensure timely distribution of documentation to appropriate departments. Direct the timely and accurate communication of information to appropriate department staff to include: Medical Exception/Prior Authorization; Medication Request Forms (MRFs); Clinical Document Maintenance, electronic prior authorization and formulary management rules, and associated tools and programs. Manage review/QA process for medical exception/prior authorization guidelines prior to implementation and distribution to clients or internal users. Serve as subject matter expert on processes related to the procedures necessary to ensure effective maintenance of MedImpact Prior Authorization program, and as a resource for PA guidelines related questions and/or inquiries from both internal and external customers Client Responsibilities: This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: CL05 - AA and 2+ years' experience or equivalent combination of education and experience Computer Skills: Intermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs. Experience with Windows based database programs is also required. Certificates, Licenses, Registrations: Must successfully complete one of the national certification exams OR obtain state licensure (in an U.S. State or Territory). Maintains a current Pharmacy Technician License and/or CPhT certification without restriction. Pay: Php50,000.00 - Php60,000.00 per month Work Location: Remote
A7 Recruitment Corporation