DutiesThe 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.Required Experience:-3+ years of Pharmacy Benefit Management (PBM) prior authorization experiencePreferred Qualifications:-Experience with PA system setup-Experience with MS Excel, Word and PowerPoint-Experience with CAS and/or MedHOK systems-Experience with Prior Auth and Appeals activities-Experience with previous project management.-Strong attention to detail and commitment to high-quality work.Required Qualifications3+ years of Pharmacy Benefit Management (PBM) prior authorization experiencePreferred QualificationsExperience 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.EducationBachelor's Degree in any related fieldVerifiable High School Diploma, GED, or equivalent.Notes:Mon-Fri - 8:30 - 5:00 central timeFully remote (never coming onsite)
At VIVA, employee well-being is paramount. Our comprehensive benefits package ensures your health, financial security, and quality of life are always prioritized.
VIVA provides employees access to a comprehensive group health insurance plan (Medical, Dental, Vision, Basic Life, Term Life, and Accidental Death) through our flexible PPO plan-allowing you the freedom to choose healthcare providers.
Plan securely for your future with automatic payroll deductions into a tax-advantaged 401(k) retirement plan, including employer-matching contributions for eligible employees.
Earn performance-based bonuses and generous referral incentives of up to $500 when recommending talented candidates who become part of the VIVA family.
Enjoy timely and convenient payroll with biweekly direct deposit to your chosen financial institution. Biweekly Direct Deposit
Access exclusive employee discounts and savings on electronics, travel, groceries, apparel, and more through our dedicated VIVA Perks Program.