Clinical Pharmacy Coordinator

🕒 July 24

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 25%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Medical Review Institute of America, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1983

🛡️ Insurance

💼 Consulting

⚖️ Legal

Insurance • Consulting • Legal

Medical Review Institute of America, LLC is a company specializing in clinical and utilization review services. They offer a comprehensive suite of data-driven solutions, including prior authorization optimization, second opinions, and specialty drug reviews, aimed at ensuring the right care is delivered at the right time and in the right place. MRIoA provides services to health plans, pharmacy benefit managers, government entities, and self-insured employers, among others. They leverage technology and a network of professionals to streamline clinical decisions, enhance provider performance, and ensure compliance with regulatory requirements across all 50 states. Their tools and platforms are designed to optimize clinical reviews, reduce costs, and improve patient outcomes through evidence-based care pathways and telehealth solutions.

📋 Description

• Carry out day-to-day departmental tasks and screen incoming pharmacy review requests • Prepare, organize, distribute, and present records, materials, and forms for pharmacy case reviews • Identify appropriate reviewers, determine availability, and deliver cases for assignment • Enter pharmacy case review data in online case summary/tracking and client systems • Receive and review reviewer decisions • Contact clients to resolve questions and obtain information, records, or materials for active cases • Respond to reviewer requests for additional information and notify clients and internal departments • Complete fax and telephone outreach to obtain missing information needed for clinical decisions • Receive inbound calls from medical professionals regarding case status or additional information • Create and maintain an in-house review file for each active pharmacy case • Respond to client, referring entity, and practitioner/provider/facility inquiries • Issue timely, accurate oral and written review outcome notifications • Research client questions about review processes and reviewer decisions • Determine the need for additional information or review and notify relevant parties • Support Quality Management and compliance program initiatives • Participate in Provider Relations assessment processes, company meetings, and committees • Adhere to policies and procedures and take responsibility for performance • Maintain a flexible schedule to meet client needs • Collaborate with and cross-train on other teams as needed • Complete other assigned duties and responsibilities

🎯 Requirements

• Minimum of one year pharmacy experience preferred • Minimum of one year in a similar operation (health insurance, healthcare and/or managed care arena) preferred • Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high priorities • Ability to work independently with minimal supervision • High level of adaptability and ability to adjust to shifting priorities • Personal computer literacy and high competency in Microsoft Word • Strong organizational skills with attention to detail • Strong oral and written communication skills • Well-developed training skills • Strong working knowledge of basic anatomy, physiology and medical terminology preferred • Strong working knowledge of medical insurance terminology and processes preferred • Strong working knowledge of prescription drug terminology preferred • Excellent critical thinking capabilities with strong attention to detail • Exceptional customer service skills • Thorough understanding and knowledge of the Company's clients, products, departments, workflows, applicable regulatory requirements, and accreditation standards • High school diploma or equivalent • Ability to sit at a desk and use a computer, telephone, and basic office equipment • Must pass a background screen before beginning employment • Must complete a drug screen after hire • Must agree to necessary compliance regulations on the first day • Must adhere to applicable HIPAA regulations and company confidentiality, privacy, and security policies

🏖️ Benefits

• A competitive compensation package • Healthcare, vision and dental insurance • Generous 401k match • Paid vacation, personal time, and holidays • Growth and training opportunities • Team atmosphere with fun events and prizes scheduled throughout the year