Remote Clinical Assistant – Prior Authorization & PBM

Vida Health, Inc.; United States; Remote; USD 30,000 - 41,000; Full time

Job summary

Vida Health, Inc. is seeking a Clinical Assistant to manage end-to-end prescribing and prior authorization workflows for anti-obesity therapies.

You will navigate PBM criteria, handle complex escalations, and ensure timely access to prescribed treatments while maintaining HIPAA compliance. This 3‑month seasonal role emphasizes leadership, autonomy, and mentoring peers, with daily collaboration across Medical Providers, Member Services, and QA teams.

Qualifications

• 3+ years of experience focused on prior authorizations or PBM navigation in medical settings.
• Proven initiative, project leadership, and mentoring abilities without direct reports.
• Deep knowledge of PA submission criteria and formulary workflows for cardiometabolic/specialty drugs.
• Excellent written and verbal communication; cross-departmental escalation resolution.

Responsibilities

• Prepare and submit accurate PA requests to PBMs and health plans.
• Autonomously manage complex exception processes and formulary overrides.
• Act as escalation point to resolve complex coverage inquiries from Medical Providers and support teams.
• Train teammates on PA guidelines and assist with PBM formulary details.
• Respond to medical provider chats and triage messages to appropriate parties.

Skills

PBM navigation

Prior authorizations

Mentoring

Communication

EHR proficiency

Time management

Education

CMA certification

Tools

CoverMyMeds

Google Suite

Slack

Job description

Vida Health, Inc. is seeking a Clinical Assistant to manage end-to-end prescribing and prior authorization workflows for anti-obesity therapies.

You will navigate PBM criteria, handle complex escalations, and ensure timely access to prescribed treatments while maintaining HIPAA compliance. This 3‑month seasonal role emphasizes leadership, autonomy, and mentoring peers, with daily collaboration across Medical Providers, Member Services, and QA teams.