Clinical Review Technician

The Clinical Review Technician works under the supervision of the licensed pharmacist on duty during day-to-day operations and reports directly to the Clinical Review Technician Supervisor. The Clinical Review Technician will perform clinical functions in supporting the daily operations of Med One Clinical Services.

Med One is a full-service pharmacy benefit manager (PBM), serving clients and members nationwide. With a fully transparent, pass-through model, Med One helps people conveniently access the most appropriate prescriptions at the most affordable price.

• Support operations of Med One Clinical Services
• Conduct clinical assessments to evaluate the appropriateness of medication therapy as part of the clinical review/prior authorization process
• Communicate clinical review decision to pharmacies and providers
• Maintain quality and productivity standards for all cases reviewed while meeting established turnaround time requirements
• Complete Proactive Prescriber Outreach Program (PPOP) calls and requests as assigned
• Provide mentorship to the Data Entry Specialist team as required
• Assist Member Advocate and Account Management teams with patient or provider requests not requiring pharmacist intervention
• Works to promote a team environment
• Support the operation and maintenance of existing Med One Clinical Service
• Assists and supports members of Med One Pharmacy Benefit Solutions
• Portrays the company in a positive image
• Required to abide by all rules, regulations and policies of the employer
• Other duties as assigned

• CPhT certification, or state equivalent at date of hire
• High school diploma or equivalent (Associate's or Bachelor's degree preferred)
• 1-3 years of experience in healthcare, pharmacy, insurance, or prior authorization support
• Detail-oriented with a high degree of accuracy
• Strong interpersonal, written, and verbal communication skills
• Ability to work independently and manage time effectively
• Excellent customer service and teamwork skills
• Must have a designated workplace (an office, spare bedroom, etc.) that is visibly secure from others during work hours (closed door) and is protected from noise that could disrupt conversations (for remote employees)
• Must have a strong understanding of Microsoft Office (Word, Excel, PowerPoint)
• Familiarity with data entry software or CRM systems (Microsoft Dynamics) is a plus
• Must be able to type at a minimum of 30 words per minute
• Must be able to work independently, meets deadlines, establish priorities, and be flexible
• Must be able to stand/sit for long periods of time within limited space
• Must be able to lift up to 25 pounds
• Must be able to work cooperatively with Med One staff

• Competitive salary and bonuses that reward your performance
• Comprehensive health, dental, and vision insurance
• 401(k) with company match to secure your future
• Generous paid time off and holidays
• Opportunities for professional growth and development
• A vibrant and collaborative work culture

We have offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States

Full-Time, Hourly/Non-Exempt

Hours may vary within our normal business hours