Remote Clinical PA & PBM Navigator

Vida-Health; United States; Remote; USD 30,000 - 42,000; Full time

Job summary

Vida is seeking a Clinical Assistant to manage end-to-end prescribing and prior authorization operations for anti-obesity medications. The role requires handling complex PBM criteria, member escalations, and ensuring timely access to prescribed therapies.

The successful candidate will demonstrate initiative, SME-level knowledge, and mentorship to peers. Strong communication and documentation skills are essential, with adherence to HIPAA and Vida QA standards.

Qualifications

• 3+ years of experience focused on prior authorizations or PBM navigation in medical settings.
• Proven initiative, project/workflow leadership, and mentoring abilities.
• Deep knowledge of PA submission criteria and formulary exception workflows for cardiometabolic drugs.
• Excellent written and verbal communication with cross-departmental escalation experience.
• Proficiency with EHR tools, PA platforms (e.g., CoverMyMeds), and cloud collaboration tools.

Responsibilities

• Prepare and submit accurate PA requests to PBMs and health plans for anti-obesity medications.
• Autonomously manage complex exception processes and formulary overrides.
• Research, troubleshoot, and resolve complex coverage inquiries from Medical Providers and care teams.
• Train team members on prior authorization guidelines and PBM formulary details as needed.
• Review and respond to medical provider chats to assist Vida Providers.

Skills

Prior authorizations

PBM knowledge

EHR tools

Communication skills

Time management

Independent work

Education

Certified Medical Assistant (CMA)

Tools

CoverMyMeds

Google Suite

Slack

EHR systems

Job description

Vida is seeking a Clinical Assistant to manage end-to-end prescribing and prior authorization operations for anti-obesity medications. The role requires handling complex PBM criteria, member escalations, and ensuring timely access to prescribed therapies.

The successful candidate will demonstrate initiative, SME-level knowledge, and mentorship to peers. Strong communication and documentation skills are essential, with adherence to HIPAA and Vida QA standards.