Clinical Assistant

Job not on LinkedIn

🔥 2 hours ago

🇺🇸 United States – Remote

💵 $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Vida Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2014

🏥 Healthcare

🍽️ Food & Beverage

💼 Consulting

Healthcare • Food & Beverage • Consulting

Vida Health is a company committed to improving health outcomes for various physical and mental health conditions, including diabetes, obesity, depression, and hypertension. They offer personalized, human-led care combined with digital technology to manage and treat these complex conditions. Vida Health partners with employers, health plans, and consultants to provide comprehensive health solutions. Their services include video chats and text-based messaging with healthcare providers, and they utilize machine learning and synced devices to personalize member care. They focus on significant cost savings and improved health outcomes for cardiometabolic conditions, guaranteeing results and offering up to 100% of fees at risk for both physical and mental healthcare.

📋 Description

• Prepare, review, and submit accurate clinical prior authorization requests to PBMs and health plans for anti-obesity medications • Autonomously manage complex exception processes and formulary overrides • Research, troubleshoot, and resolve complex coverage inquiries and prescribing-related escalations • Serve as a liaison between the Clinical Assistant team and PBM formulary details • Assist with training team members on complex prior authorization guidelines • Review and respond to medical provider chat messages • Triage messages to appropriate parties • Drive timely issue resolution while meeting ticket-handling and message-review KPIs • Manage daily workload priorities, monitor queues, and maintain team SLAs • Partner with multidisciplinary care teams on member prescribing plans and medication access status • Maintain confidentiality and adhere to HIPAA guidelines regarding PHI • Use Zendesk ticketing workflows, internal tools, and communication templates • Accurately document hours worked using designated ADP pay codes • Follow QA, compliance, and clinical protocol guidelines • Perform other assigned clinical support and operational duties

🎯 Requirements

• 3+ years of experience focused on prior authorizations or PBM navigation within a medical clinic, specialty pharmacy, health plan, or telehealth environment • Proven track record of taking initiative, leading projects or workflow improvements, and mentoring or guiding colleagues without requiring formal direct report management • Deep knowledge of prior authorization submission criteria, PBM formulary exception workflows, navigating prescribing protocols, and clinical documentation for cardiometabolic/specialty drugs • Excellent written and verbal communication skills with a proven ability to resolve cross-departmental escalations diplomatically • Proficiency in electronic health record (EHR) tools, prior authorization platforms (e.g., CoverMyMeds), and cloud collaboration tools (Google Suite, Slack) • Strong organization, time-management, and analytical skills with the ability to operate independently in a fast-paced environment • Able to work Monday through Friday between 8:00 AM and 8:00 PM in the candidate’s local time zone • Certified Medical Assistant (CMA), or related healthcare certification (preferred) • Previous experience in a virtual care, digital health, or high-growth startup setting (preferred) • Proficiency in using telehealth technology (preferred) • Ability to multitask and prioritize in a fast-paced environment (preferred) • Compassionate and patient-centered approach to care (preferred) • Strong organizational skills and attention to detail (preferred)

🏖️ Benefits

• Possibility of extension beyond the 3-month seasonal position based on performance and business needs • Equal Employment Opportunity and Affirmative Action employer • Reasonable accommodations for qualified individuals with disabilities and disabled veterans