Clinical Review Technician - CPhT Required

Medone Pharmacy Benefit Solutions•Dubuque, IA

23h•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 What You'll Bring to MedOne 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) 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 MedOne? At MedOne, we believe that a healthy team is a happy team. We offer a collaborative work environment, competitive benefits, and opportunities for growth—all while helping to make a difference in people’s lives. Our top core value is to prioritize your well-being. To support you in living this value, we offer: Competitive salary and bonuses that reward your performance. Comprehensive health, dental, and vision insurance + additional benefits 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: Offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States. Employment Type: Full-Time, Hourly Reports to: Clinical Review Technician Supervisor 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. 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.

Requirements

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