Job Description:
• Provide technical and administrative support to the Fee-For-Service (FFS) Medicaid department
• Create and maintain PA Guidelines documents (content management, file maintenance and archiving)
• Provide technical and administrative support to the Clinical Program Manager, Clinical PA Guidelines, Drug Information and PA&UM staffs
• Communicate with clients to obtain client authorization of final documents and ensure timely distribution
• Manage review/QA process for medical exception/prior authorization guidelines prior to implementation
Requirements:
• CL05 - AA and 2+ years’ experience or equivalent combination of education and experience
• Intermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs
• Experience with Windows based database programs
• Must successfully complete one of the national certification exams OR obtain state licensure (in an U.S. State or Territory)
• Maintains a current Pharmacy License and/or CPhT certification without restriction
• Understanding of managed pharmacy benefit concepts including formularies, prior authorizations, edits, and claim adjudication
Benefits:
• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus
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