Job Summary
About us:
Medical Review Institute of America (MRIoA) is the market leader for technology-enabled utilization management (UM) and clinical review solutions - touching over 35M lives. For over 36 years, MRIoA has perfected the utilization and clinical review process for payers of medical claims. We offer the largest, most extensive review network in the industry. We have over 30 internal Medical Directors, 26 Nurses and 500+ Physicians across 150+ specialties with licensure in all 50 states.
Position Summary:
Position is responsible for carrying out day-to-day departmental tasks and complete all processes for screening incoming pharmacy review requests and/or completing review for client.
Brief Description of Major Responsibilities or Assigned Duties:
Screen incoming pharmacy review requests for completeness of materials required to conduct the review of the case.
Prepare, organize, distribute and present records, materials and forms required for a complete pharmacy case review packet for Physician Reviewers.
Identify appropriate Physician Reviewers for pharmacy case review assignment including: determine their availability for a review assignment and obtain information for delivery of the case to the Reviewer if applicable.
Contact clients to resolve questions, obtain information, records and/or materials needed for a pharmacy case review and resolve issues about active cases.
Respond to Physician Reviewers' requests for additional information/materials necessary for a review and notify clients and other internal departments of these needs, as applicable.
Additional responsibilities as required.
Qualifications/Skills:
Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high priorities.
Ability to work independently with minimal supervision.
Personal computer literacy and high competency in use of Microsoft Word.
Strong attention to details.
Very strong oral and written communication skills.
Experience:
Minimum of one year in a similar operation preferred (health insurance, healthcare and/or managed care arena).
Minimum of one year pharmacy experience strongly preferred.
Requirements:
Pharmacy Technician Certification preferred, healthcare experience required.
High school diploma or equivalent required.
We Offer:
An opportunity to work with healthcare professionals, including doctors, nurses, and pharmacists, in an administrative office setting.
A team atmosphere with fun events, and chances to win prizes.
Growth and training opportunities; we promote from within with a Career Pathing plan.
Generous benefits including great healthcare, vision, dental, insurance, a huge 401k match, vacation and personal time, paid holidays, and a holiday and a profit sharing bonus.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
MRIoA is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment.
