LanceSoft Inc., ยท 12 hours ago
'Prior Authorization Clinical Operations Consultant' - Work from Home
United States
Contract
Remote
Mid Level
$23/hr - $26.32/hr
3+ years expLanceSoft Inc. is a company dedicated to helping people on their path to better health. They are seeking a Clinical Operations Consultant who will act as a Subject Matter Expert for Prior Authorization, providing administrative support and ensuring compliance while collaborating with various internal and external teams.
Information Technology & Services
Responsibilities
The Clinical Services Consultant fulfills the company purpose of helping people on their path to better health by driving quality execution of administrative support for Prior Authorization
The Clinical Services Consultant will be a Prior Authorization system Subject Matter Expert providing support for the Prior Authorization/Appeals Operational and Administrative teams
This position works closely with and fosters communications with internal and external departments including clinical development, product owners, CAS liaisons, Account Teams and Prior Authorization Operations to ensure a solid understanding of the programs being processed and implemented
Daily Configuration & Document Management
Configure criteria documents and fax forms into the Prior Authorization system daily, ensuring accuracy and completeness
Link workload to specific drug classes and clients
Validate all configurations for compliance and operational standards
In order to be successful in this role you will interact and collaborate with internal colleagues to identify opportunities to improve processes and drive efficiencies within the department as well as assist in leading meetings, creation and maintenance of work instructions, training, projects and activities related to PA systems
Consultants also work with a team of system trainers to provide consistent back end user support, assist in documentation and maintenance of user guides presentations and corrective action plans, provide system demos and help guide CAS users through the implementation process for Prior Authorization system tool
Qualification
Required
3+ years of Pharmacy Benefit Management (PBM) prior authorization experience
Bachelor's Degree in any related field
Verifiable High School Diploma, GED, or equivalent
Preferred
Experience with PA system setup
Experience with MS Excel, Word and PowerPoint
Experience with CAS and/or MedHOK systems
Experience with Prior Auth and Appeals activities
Strong attention to detail and commitment to high-quality work
Company
LanceSoft Inc.,
Established in 2000, LanceSoft is a pioneer in delivering top-notch Global Workforce Solutions and IT Services to a diverse clientele.
5001-10000 employees
H1B Sponsorship
LanceSoft Inc., has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (55)
2024 (32)
2023 (23)
2022 (25)
2021 (60)
2020 (80)
Funding
Current Stage
Late StageCompany data provided by crunchbase