Clinical Assistant

📋 Description

• Prepare, review, and submit accurate, clinical prior authorization requests to PBMs and health
• Autonomously manage complex exception processes and formulary overrides.
• Act as a key escalation point to research, troubleshoot, and resolve complex coverage inquiries
• Serve as a knowledgeable liaison between Clinical Assistant team and PBM formulary details for
• Assist Vida Medical Providers by reviewing and responding to medical provider chat messages.
• Triage messages to appropriate parties as needed.

🎯 Requirements

• 3+ years of experience focused on prior authorizations or PBM navigation within a medical clinic
• Proven track record of taking initiative, leading projects or workflow improvements, and mentoring
• Deep knowledge of prior authorization submission criteria, PBM formulary exception workflows
• Excellent written and verbal communication skills with a proven ability to resolve
• Proficiency in electronic health record (EHR) tools, prior authorization platforms (e.g.
• Strong organization, time-management, and analytical skills with the ability to operate