Clinical Operations Consultant

Amicis Global; Alaska; Remote; USD 83,000 - 124,000; Full time

Benefits offered by this job

Remote work

6-month engagement

Job summary

Amicis Global is seeking a Clinical Operations Consultant to drive quality execution of administrative support for Prior Authorization, on a fully remote basis for a 6‑month engagement. You will configure criteria documents and forms daily, link workloads to drug classes, and validate configurations for compliance and operational standards.

You will also lead meetings, develop work instructions, train users, and present system demos to CAS and clinical teams.

Qualifications

• 3+ years of PBM prior authorization experience.
• Experience configuring PA system/workflows.
• Ability to collaborate across teams and document processes.

Responsibilities

• Configure criteria documents and fax forms in the Prior Authorization system daily.
• Link workload to specific drug classes and clients.
• Validate configurations for compliance and operational standards.
• Lead meetings, create and maintain work instructions, training, projects and activities related to PA systems.
• Provide system demos and guide CAS users through implementation.
• Collaborate with internal and external teams to identify opportunities to improve processes and drive efficiencies.

Skills

Prior authorization experience

Project management

Attention to detail

Education

Bachelor's Degree in related field

High School Diploma or equivalent

Tools

MS Excel

MS Word

PowerPoint

CAS or MedHOK systems

Prior Authorization system

Job description

Job Title

Clinical Operations Consultant

Job Location

Fully Remote

Job Duration

6 Months

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.

Required Experience

• 3+ years of Pharmacy Benefit Management (PBM) prior authorization experience

Preferred Qualifications

• 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
• Experience with previous project management.
• Strong attention to detail and commitment to high-quality work.

Education

• Bachelor's Degree in any related field
• Verifiable High School Diploma, GED, or equivalent