The Clinical Associate supports pharmacy benefit operations by coordinating clinical workflows, processing prior authorizations, and managing appeals. They also provide customer service to members and providers while ensuring compliance with regulatory standards and internal policies.
The Prior Authorization Pharmacist evaluates pharmacy prior authorization requests to ensure appropriate medication use based on clinical criteria and benefit plans. They also provide clinical leadership, support utilization management initiatives, and collaborate with healthcare providers to optimize therapeutic outcomes.
The Account Executive serves as the primary point of contact for clients, collaborating with internal teams to ensure satisfaction and program performance. They are responsible for analyzing client data, facilitating strategic meetings, and identifying opportunities to improve healthcare cost outcomes.
