Clinical Associate

Under general supervision, the Clinical Associate provides assistance to members, pharmacists, or physicians regarding prescription services and prior authorization activities in accordance with established policies and procedures, laws and regulations.

QUALIFICATIONS

Education: High School Diploma, G.E.D., or equivalent. Certified Pharmacy Technician required. Experience: Previous case management and pharmacy experience preferred. Knowledge, Skills, and Abilities: Knowledge of Microsoft Windows, including word processing and spreadsheet applications Good computer skills in general with the ability to learn new software programs and applications Strong organizational skills Ability to effectively communicate with internal and external clients Ability to multi‑task Excellent analytical skills

ESSENTIAL FUNCTIONS

(These duties must be performed with or without reasonable accommodation. This document in no way states or implies that these are the only duties to be performed by the employee occupying this position): Contact providers to gather clinical information and to discuss individual members' cases. Contact and confer with pharmacists and physicians regarding questions or irregularities on prescriptions. Processes authorizations including the input of new authorizations, refill of new authorizations, request of new authorizations and the review process of authorizations. Work directly with Customer Service Representatives as a resource for formulary and plan-related questions. Maintain current knowledge of plan specifications and requirements. Maintain current knowledge of drug therapies and drug reactions and interactions by reading professional literature, attending seminars and through professional affiliations. Work with clinical managers, Customer Service Manager, staff, and clients in developing and carrying out various clinical initiatives. Attend and participate in other programs, committees, meetings, and functions as required. Maintains regular attendance in accordance with established policies. Perform other job-related duties as assigned. Promptly report any allegations of impropriety to the Compliance Department. Comply with Maxor's Ethical Business Conduct policy and Maxor's Compliance Program. Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists. Complete required training, as assigned, within the established timeframes. Must be able to cope with the mental and emotional stress of the position. Maxor offers competitive wages and a comprehensive benefit package, including group health, company paid LTD and basic life/AD&D, paid time off, employer matched 401k plan, and more, are available. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr Maxor