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Clinical Operations Consultant

Lancesoft

Please note: Actual location may vary., RI(remote)

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JOB DETAILS
SALARY
$26.32
LOCATION
Please note: Actual location may vary., RI
POSTED
6 days ago
Job ID: 26-62302
Position Type: Full time
Location: Fully Remote
Work Type: Remote
Est. Pay Range: $26.32/hr. To $27.68/hr.
 
Schedule: Monday –Friday - 08: 30 - 05: 00 CST
 
Position Summary:
  • The Clinical Services Consultant fulfils 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.
Duties:
  • 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 Qualifications:
  • 3+ years of Pharmacy Benefit Management (PBM) prior authorization experience 
Preferred 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. 
Education:
  • Bachelor's Degree in any related field
  • Verifiable High School Diploma, GED, or equivalent.
Employee Benefits:
At LanceSoft, full-time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:
  • Four options of medical Insurance
  • Dental and Vision Insurance
  • 401k Contributions
  • Critical Illness Insurance
  • Voluntary Permanent Life Insurance
  • Accident Insurance
  • Other Employee Perks
LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.
 
 

About the Company

L

Lancesoft

We are a $125 Million, NMSDC-certified Minority & Woman owned Workforce Solutions Company headquartered in the DC metro area with presence across US with global presence - Canada, Mexico, India, UK, Malaysia, Indonasia, Hongkong, Singapore, UAE. We are specialized in providing Workforce Solutions, SOW project delivery, Engineering Solutions, Creative Services. We currently support 100+ Fortune companies globally and across multiple industry segments. We are currently supporting several massive programs across industry segment nationally/globally (Intel, Ally, AMD, QUALCOMM, Morgan Stanley, Kraft/ Mondelez, MNP, Amdocs, Dell, SanDisk, Medtronic, Becton Dickinson, GE, Lockheed Martin, UTC, L-3 Communications, Caterpillar, BMW, Mercedes Benz, National Grid, Dominion, Energy Future Holdings, PSEG, 3M, Fidelity, Aetna, Humana, Johnson & Johnson, Pfizer, Merck etc). 

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.

COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Staffing/Employment Agencies
FOUNDED
2000
WEBSITE
http://www.lancesoft.com/

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