Clinical Review Technician - CPhT Required

MedOne Pharmacy Benefit Solutions•Dubuque, IA

1d•Remote

About The Position

Position Overview: MedOne is hiring a detail-oriented clinical reviewer that is a certified pharmacy technician to assess medication therapy, support prior authorization processes, mentor data entry staff, and collaborate across teams to ensure timely, high-quality service delivery. 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'll Do: 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 Services 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

Requirements

Familiarity with PAHub processes; with 6-12 months of relevant DES experience within the last 12 months preferred.
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)
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

Nice To Haves

Familiarity with PAHub processes; with 6-12 months of relevant DES experience within the last 12 months preferred.
Familiarity with data entry software or CRM systems (Microsoft Dynamics) is a plus.

Responsibilities

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 Services
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