Clinical Pharmacy Coordinator

🔥 5 hours ago

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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

• Responsible to carry out day-to-day departmental tasks and complete all processes for screening incoming pharmacy review requests • Prepare review information and materials for assignment to appropriate reviewers • Enter pharmacy case review data in the online case summary/tracking system • Receive and review Reviewer decisions • Complete outreach over the phone to gather additional information for cases • Take inbound phone calls from medical professionals • Issue appropriate, timely and accurate review outcome notifications and completion of pharmacy case review data in the online case summary/tracking system and client system • Finalize the pharmacy case review process and issue review outcome notifications to appropriate parties of the case • Serve as a company liaison with clients, reviewers and practitioners/providers/facilities whose services are subject to review.

🎯 Requirements

• Minimum of one year pharmacy experience preferred • Minimum of one year in a similar operation preferred (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, evidenced by the ability to thrive in dynamic environments and rapidly adjust to shifting priorities • Personal computer literacy and high competency in use of Microsoft Word • Strong organizational skills with attention to details • 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 a strong attention to detail • Exceptional customer service skills • Thorough understanding and knowledge of Company's clients, products, departments and workflows, and applicable regulatory requirements and accreditation standards.

🏖️ Benefits

• healthcare, vision and dental insurance • a generous 401k match • paid vacation • personal time • holidays • Growth and training opportunities • A team atmosphere with fun events and prizes scheduled throughout the year