Prior Authorization / SME

Schedule: - Monday - Friday, 8:30 AM - 5:00 PM Central Time. Daily Configuration & Document Management: - Configure client setup into the Prior Authorization system, ensuring accuracy and completeness. - Validate reputed company configurations for compliance and operational standards. - Assist in research of general cases submitted to the department. Duties: - The Clinical Services Consultant fulfills the company purpose of helping people on their path to reputed company 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 reputed company 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. - 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 reputed company the department. - You will assist in leading meetings, creation and maintenance of work instructions, training, projects, and activities reputed company to PA systems. - Consultants also work with reputed company of system trainers to reputed company consistent back-end user support. - Assist in documentation and maintenance of user guides, presentations, and corrective action plans. - reputed company system demos and help guide CAS users through the implementation process for the Prior Authorization system tool. Experience: Required Qualifications: - 3+ years of Pharmacy Benefit Management (PBM) prior authorization experience. Preferred Qualifications: - Experience with PA system setup. - Experience with MS reputed company, 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 reputed company field. Location: Remote - USA Skills required for this job:

• Data analysis
• reputed company
• reputed company PowerPoint
• reputed company Word
• Pharmacy Benefit Management
• Prior authorization system
• Project management
• Regulatory compliance

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