Position Overview: The Clinical Review Technician works under the supervision of the licensed pharmacist on duty during day-to-day operations and reports directly to the Clinical Review Technician Supervisor. The Clinical Review Technician will perform clinical functions in supporting the daily operations of MedOne Clinical Services.   About MedOne: 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.   What You Will Do at MedOne: Support operations of MedOne Clinical Services Conduct clinical assessments to evaluate the appropriateness of medication therapy as part of the clinical review/prior authorization process Communicate clinical review decision to pharmacies and providers Maintain quality and productivity standards for all cases reviewed while meeting established turnaround time requirements Complete Proactive Prescriber Outreach Program (PPOP) calls and requests as assigned Provide mentorship to the Data Entry Specialist team as required Assist Member Advocate and Account Management teams with patient or provider requests not requiring pharmacist intervention Works to promote a team environment Support the operation and maintenance of existing MedOne Clinical Service Assists and supports members of MedOne Pharmacy Benefit Solutions Portrays the company in a positive image Required to abide by all rules, regulations and policies of the employer Other duties as assigned   What you will bring to MedOne: CPhT certification, or state equivalent at date of hire High school diploma or equivalent (Associate’s or Bachelor’s degree preferred) 1–3 years of experience in healthcare, pharmacy, insurance, or prior authorization support Detail-oriented with a high degree of accuracy Strong interpersonal, written, and verbal communication skills Ability to work independently and manage time effectively Excellent customer service and teamwork skills Must have a designated workplace (an office, spare bedroom, etc.) that is visibly secure from others during work hours (closed door) and is protected from noise that could disrupt conversations (for remote employees) Must have a strong understanding of Microsoft Office (Word, Excel, PowerPoint) Familiarity with data entry software or CRM systems (Microsoft Dynamics) is a plus Must be able to type at a minimum of 30 words per minute Must be able to work independently, meets deadlines, establish priorities, and be flexible Must be able to stand/sit for long periods of time within limited space Must be able to lift up to 25 pounds Must be able to work cooperatively with MedOne staff   Why Join MedOne? Competitive salary and bonuses that reward your performance Comprehensive health, dental, and vision insurance 401(k) with company match to secure your future Generous paid time off and holidays Opportunities for professional growth and development A vibrant and collaborative work culture   Location: We have offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States Employment Type: Full-Time, Hourly/Non-Exempt Hours: Hours may vary within our normal business hours   How to Apply: If you're enthusiastic about helping others and eager to join a dynamic team, we’d love to hear from you. Apply now and take the first step toward a rewarding career at MedOne! You can submit your application through our careers page. MedOne is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.   Job Offers are contingent on passing a background check and drug screen.

CPhT certification or state equivalent; high school diploma; 1-3 years healthcare/pharmacy/insurance/prior authorization experience; Microsoft Office proficiency; 30 WPM typing; ability to lift 25 lbs; remote workspace requirements.

Key Responsibilities

• conducting clinical assessments
• communicating review decisions
• maintaining quality standards

Skills & Tools

Microsoft Office, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Dynamics

Job Details

• Category: Healthcare Services - Pharmacy
• Seniority: Entry Level
• Commitment: Full Time
• Workplace: Remote — United States or Dubuque or Kansas City
• Languages: English

Benefits

• 401k matching
• Generous paid time off
• Retirement plan

About MedOne Pharmacy Benefit Solutions

A full-service pharmacy benefit manager providing transparent, pass-through prescription access. — Industry: Healthcare