RemoteDescription:The Clinical Operations Consultant fulfills the company purpose of helping people on their path to better health by driving quality execution of administrative support for Prior Authorization. The Clinical Operations Consultant will be a Prior Authorization system Subject Matter Expert providing support for the Prior Authorization/Appeals Operational and Administrative teams. This position works closely with and fosters communications with internal and external departments including clinical development, product owners, CAS liaisons, Account Teams and Prior Authorization Operations to ensure a solid understanding of the programs being processed and implemented.DutiesThis is for a Clinical Services Consultant role under the Letters department with a basic technical background to carry out specific duties to that department listed below:Formatting of letter templates to work within the CAS Administration systemCreation and formatting of rationale templatesCreation and formatting of formulary listsBasic formatting example: When a new job is added to a resume and suddenly everything becomes unaligned. You would then format the resume to make it look correct.The Clinical Services Consultant fulfills the company purpose of helping people on their path to better health by driving quality execution of administrative support for Prior Authorization. The Clinical Services Consultant will be a Prior Authorization system Subject Matter Expert providing support for the Prior Authorization/Appeals Operational and Administrative teams. This position works closely with and fosters communications with internal and external departments including clinical development, product owners, CAS liaisons, Account Teams and Prior Authorization Operations to ensure a solid understanding of the programs being processed and implemented.In order to be successful in this role you will interact and collaborate with internal colleagues to identify opportunities to improve processes and drive efficiencies within the department as well as assist in leading meetings, creation and maintenance of work instructions, training, projects and activities related to PA systems. Consultants also work with a team of system trainers to provide consistent back end user support, assist in documentation and maintenance of user guides presentations and corrective action plans, provide system demos and help guide CAS users through the implementation process for Prior Authorization system tool.ExperienceRequired Qualifications:3+ years of Pharmacy Benefit Management (PBM) prior authorization experiencePreferred Qualifications:Experience with PA system setupExperience with MS Excel, Word and PowerPointExperience with CAS and/or MedHOK systemsExperience with Prior Auth and Appeals activitiesExperience with previous project management.Strong attention to detail and commitment to high-quality work.Daily Configuration & Document ManagementConfigure client setup into the Prior Authorization system ensuring accuracy and completenessValidate all configurations for compliance and operational standardsAssist in research of general cases submitted to the departmentEducationBachelor's Degree in any related fieldVerifiable High School Diploma, GED, or equivalent.Notes:Mon-Fri - 8:30a - 5:00p CTFully remote (never coming onsite)safety sensitiveVIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Description:The Clinical Operations Consultant fulfills the company purpose of helping people on their path to better health by driving quality execution of administrative support for Prior Authorization. The Clinical Operations Consultant will be a Prior Authorization system Subject Matter Expert providing support for the Prior Authorization/Appeals Operational and Administrative teams. This position works closely with and fosters communications with internal and external departments including clinical development, product owners, CAS liaisons, Account Teams and Prior Authorization Operations to ensure a solid understanding of the programs being processed and implemented.DutiesThis is for a Clinical Services Consultant role under the Letters department with a basic technical background to carry out specific duties to that department listed below:Formatting of letter templates to work within the CAS Administration systemCreation and formatting of rationale templatesCreation and formatting of formulary listsBasic formatting example: When a new job is added to a resume and suddenly everything becomes unaligned. You would then format the resume to make it look correct.The Clinical Services Consultant fulfills the company purpose of helping people on their path to better health by driving quality execution of administrative support for Prior Authorization. The Clinical Services Consultant will be a Prior Authorization system Subject Matter Expert providing support for the Prior Authorization/Appeals Operational and Administrative teams. This position works closely with and fosters communications with internal and external departments including clinical development, product owners, CAS liaisons, Account Teams and Prior Authorization Operations to ensure a solid understanding of the programs being processed and implemented.In order to be successful in this role you will interact and collaborate with internal colleagues to identify opportunities to improve processes and drive efficiencies within the department as well as assist in leading meetings, creation and maintenance of work instructions, training, projects and activities related to PA systems. Consultants also work with a team of system trainers to provide consistent back end user support, assist in documentation and maintenance of user guides presentations and corrective action plans, provide system demos and help guide CAS users through the implementation process for Prior Authorization system tool.ExperienceRequired Qualifications:3+ years of Pharmacy Benefit Management (PBM) prior authorization experiencePreferred Qualifications:Experience with PA system setupExperience with MS Excel, Word and PowerPointExperience with CAS and/or MedHOK systemsExperience with Prior Auth and Appeals activitiesExperience with previous project management.Strong attention to detail and commitment to high-quality work.Daily Configuration & Document ManagementConfigure client setup into the Prior Authorization system ensuring accuracy and completenessValidate all configurations for compliance and operational standardsAssist in research of general cases submitted to the departmentEducationBachelor's Degree in any related fieldVerifiable High School Diploma, GED, or equivalent.Notes:Mon-Fri - 8:30a - 5:00p CTFully remote (never coming onsite)safety sensitive
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