Clinical Services Specialist

**Overview****Scope of Responsibilities: Assist with the day-to-day operations of the Clinical Pharmacist and clinical department of ProAct. Works under direct supervision and follows standard procedures to accomplish assigned tasks.Job Summary: Responsibility for overseeing the prior authorization process, initial prior authorization review, and assisting with tasks and goals that meet the clinical needs of ProAct clients and members.Responsibilities****Job Duties:+ Oversee the prior authorization process to maintain efficiency and timeliness.+ Review prior authorization requests based on currently-available guidelines+ Provide Help Desk support, where appropriate, for questions regarding overrides or system edits+ Responsible for working with Implementation Department for loading prior authorization data for new clients when appropriate+ Assist in preparation of member mailings for various cost containment/clinical programs.+ Assist both members and Noble Health Services in finding most cost-effective channels for specialty medications+ Maintain records of all prior authorizations completed by ProAct+ Providing reports on monthly basis+ Providing data for Accounting Department for invoicing+ Assist in the development and updating of formulary documents+ Responsible for completing all mandatory and regulatory training programs+ Assist with the day-to-day operations of the ProAct Help Desk+ Perform other duties as assignedQualifications****Attendance Requirements:+ Must be available, and on-time for scheduled work shiftsEducational Requirements:+ Minimum: High School Diploma (or currently enrolled) or GED+ Preferred: AS Degree or HigherRequired:+ National Pharmacy Technician Certification through PTCB, or other accrediting agency, in good standing.Experience:+ Preferred hospital or retail pharmacy experience preferredSpecial Conditions of Employment:+ Drug test+ Initial and continuous exclusion and sanction/disciplinary monitoring+ Any and all additional eligibility requirements based on the specific positionRequired Training:+ HIPPA Privacy Course and CE Mastery Exam+ HIPPA Security Course and CE Mastery ExamJob Skills Required:+ Strong Communication Skills: Must be able to effectively communicate both on the phone and in group setting+ Strong Organizational Skills+ Proficient in using Microsoft Excel, Word, and Access+ Must be able to work independentlyBehavioral Traits :+ Cooperation: Must work harmoniously and effectively with fellow employees, supervisors and other in contact with+ Initiative: Must work within supervision guidelines and assume additional responsibilities+ Flexibility: Must be willing to work variable work schedules, assist others as requested and available, and be willing to perform all assigned work+ Adaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiences+ Involvement: Must enjoy the demands of the job and work with interest and enthusiasm+ Customer Service: Must provide appropriate customer service (for Kinney customers, fellow employees and business partners), listen attentively to their needs and respond appropriately+ Safety: Must take care of equipment and employ good safety habits+ Leadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teamsCompensation:**$17.76 - 19.31 an hourThe final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education.KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.Connect With Us!

(https://kphcareers-kphhealthcareservices.icims.com/jobs/12202/clinical-services-specialist/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866)Job LocationsUS-NY-East Syracuse, NY | US-NY-GouverneurPosted Date4 weeks ago(2/12/2024 3:24 PM)Requisition ID2024-12202\# of Openings1CategoryHealthcareLocation : LocationUS-NY-East Syracuse, NY