Job Requirements:[Minimum five years of pharmacy experience.[CPhT certification.[Minimum two years of claim adjudication experience.[Minimum two years of prior authorization experience,[customer service orientation and commitment to delivering concierge-levelservice.[Ability to work in a fast-pacedenvironment. T[ime management skills with the ability to meet tightdeadlines.[Verbal and written communication skills.[Proficient in Microsoft Office Suite.[BS (Bachelor's) Preferred.[Two years of experience in PBM, health plan, or equivalent preferred.Ability to work in office 5 days per week.

Job Responsibilities:[Serve as an account support to internal Health teams for adjudication, clinical review, and claims support-related matters.[Ensure timely completion of day-to-day processes and assigned cases, adhering to standard operating procedures.[Address escalation requests within a targeted 2-hour turnaround time.[Manage claims override and prior authorization support, delivering exceptional white-glove service to clients and members.[Act as a subject matter expert on the adjudication platform, demonstrating a keen understanding of claims support.[Perform under the supervision of the ClinOps Manager and clinical pharmacists.[Communicate and interact with all other Health departments, fostering teamwork and unity.[Company is experiencing unprecedented growth, and we're seeking a highly skilled and experienced clinical operations specialist. In this critical role, you will ensureproficiency with the adjudication platform, understand claim processing, and provide clinical review support. Clinic Ops staff must operate effectively for clients/members by assisting in support for overrides and clinical reviews promptly to ensure members are receiving white glove service. Clinical Operations will closely and collaboratively work with a call center, clinical pharmacists, and other internal Health teams.[If you're a highly motivated Clinical Operations Specialist with a robust grasp of pharmacy adjudication processes and clinical review procedures and are eager to make a meaningful impact in the healthcare industry, we encourage you to apply.We are a collaborative team that encourages groundbreaking ideas, values open dialogue, and prioritizes continuous improvement.You will be part of a dynamic team where success is a shared celebration, collaboration fuels progress, and we redefine healthcare together.We offer a generous and competitive benefits package.[]{style="font-siz

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