Prior Authorization Guidelines Specialist I (CPhT)

Exemption Status:United States of America (Non-Exempt)$22.99 - $30.35 - $37.71“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”This position is not eligible for Sponsorship.MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!Job DescriptionSummaryProvide technical and administrative support to the Fee-For-Service (FFS) Medicaid department, primarily by  working  directly  with  the  client  teams,  Clinical  Program  Managers  (CPMs),  Clinical  Specialists,  and Clinical PA Guidelines/Drug Information Management staff to create and support the appropriate administration  of  pharmacy  information  to  include  Medication  Request  Guidelines,  Medication  Request Forms (MRFs), and electronic rules. Support PA in researching PA-related tasks, PA Implementation and perform Prior Authorization processing as needed.Essential Duties and Responsibilities include the following. Other duties may be assigned.Create and maintain PA Guidelines documents (content management, file maintenance and archiving, coding and linking in on-line electronic systems).Provide technical and administrative support to the Clinical Program Manager, Clinical PA Guidelines, Drug  Information  and  PA&UM  staffs  with  the  Medication  Request  process  to  include  formatting, verifying and testing of client Medication Request Guidelines (custom and standard) and formatting/development of Medication Request Forms (MRFs) and electronic rules.Communicate with clients to obtain client authorization of final documents and ensure timely distribution of documentation to appropriate departments. Direct the timely and accurate communication of information to appropria...