Clinical Audit Coordinator, Pharmacy

This is a fully remote position, open to applicants in Arizona, +3 more states.

📋 Description

• Conduct audits of prior authorization activities

• Discover opportunities for enhancing processes

• Aid in clinical training initiatives

• Help uphold the integrity of essential pharmacy systems and data

• Collaborate with business groups to pinpoint and rectify errors in data and reporting

• Assist in managing audit processes and tools related to prior authorizations, appeals, quality improvement, star measurement reviews, inter-rater reliability, and data entry

• Evaluate training needs and select or create suitable training programs, including training aids and materials

• Support staff training in utilizing audit tools and recognizing patterns or trends that necessitate additional training or corrective measures

• Keep records of training activities and employee progress

• Engage in Quality and Advisory committees or provider education meetings

⛳️ Requirements

• Certified Pharmacy Technician (CPhT) with experience in Compass, TruCare, or CareCentral

• Quality assurance for MedPharm (TruCare, ComPass, and CareCentral) prior authorization requests

• Clinical knowledge of Medicare, Medicaid, Exchange, and Commercial plans is advantageous

• Proficiency in Microsoft Excel & Access

• 2+ years of experience as a pharmacy technician in a managed care or healthcare environment

• Audit experience is preferred

• Current State licensure or Certified Pharmacy Technician (CPhT) is preferred

🏝️ Benefits

• Competitive salary

• Health insurance coverage

• 401K and stock purchase options

• Tuition reimbursement programs

• Paid time off in addition to holidays

• Flexible work arrangements including remote, hybrid, field, or office schedules