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Clinical Review Coordinator

MedOne Pharmacy Benefit Solutions

1 Positions

ID: 2118

Posted On 12/01/2021

Job Overview

Position Description:
· Support operations of MedOne Clinical Services
· Initiate Prior Authorization requests
· Review incoming Prior Authorization documentation for completeness
· Prepare clinical review documentation for review by a MedOne Clinical Pharmacist
· Communicate clinical review decision to pharmacies and providers
· File completed Prior Authorization documentation
· Enter Clinical Review determination into the claims processing system(s) 
· Communicate the status of Clinical Reviews with patients
· Schedule Clinical Review Denial Calls with a Clinical Pharmacist 
· Update Clinical Authorization Criteria and Clinical Review Request Forms under the direction of a Clinical Pharmacist
 
Position Requirements:
· Must be registered with the state/Iowa Board of Pharmacy as a Pharmacy Technician/Trainee within 30 days of accepting employment
· Employee must be in good standing with the state board
· Working knowledge of medical terminology, HIPAA regulations, ICD-10, NCPDP standards (highly advantageous)
· Must be detail-oriented and precise
· Must have excellent interpersonal, written, and verbal skills
· Strong customer service and teamwork skills
· Must have a strong understanding of Microsoft Office (Word, Excel, PowerPoint)
· Must be able to work independently, meets deadlines, establish priorities and be flexible
 
Work Hours:
· Full-time, salaried position, minimum of 40 hours per week
· Corporate Office – Dubuque

Primary Contact

1659977850123

Jolene Kohlenberg

HR Manager,

5632584482

Phone

Phone

Phone

Fax

jkohlenberg@medone-rx.com

Email

True

True

True

Job Details

Categories

Clerical/Office Administration
Customer Service
Health Care
Pharmacy

Location

Dubuque, IA

Shift

First Shift

Job Type

Employee

Full/Part

Full Time

Benefits

Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Retirement Plan
Paid Vacation
Paid Holidays
Tuition Reimbursement

Company ID

1152

Job REQ #

# Positions

1

Start Date

20211201

End Date

20220217

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MedOne Pharmacy Benefit Solutions

About the Company

Company Information

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.  MedOne's corporate office is located in Dubuque, IA.

Why Join the MedOne Movement?

To help people conveniently access the most appropriate prescription treatment at the most affordable price.

Our Core Values:

  1. Prioritize your well-being
  2. Act as a MedOne team
  3. Care for Members with Compassion
  4. Strive to exceed client expectations
  5. Do the right things for the right reasons
  6. Bring your best
  7. Challenge the status quo

Benefits:

  • Competitive Salary
  • Medical, Dental, Vision, Disability and Life Insurance for full-time employees
  • Matching 401K Plan
  • Paid Time Off
  • Paid Holidays and Birthdays
  • Gym Reimbursement
  • Tuition Reimbursement
  • Career Growth Opportunities

MedOne is an equal opportunity employer.

Job Offers are contingent on passing a background check and drug screen.