Clinical Assistant

ABOUT US   At Vida, we help people get better- and we're helping the healthcare system get better, too.   Vida is a virtual, personalized obesity care provider that uses evidence-based treatment to help patients manage obesity and related conditions like diabetes, high blood pressure, anxiety and depression. Vida's team of Obesity Medicine-Certified Physicians, Registered Dietitians, Expert Coaches and Licensed Therapists takes a whole-person approach to care, helping people lose weight, reduce stress and improve their overall health.   By combining advanced technology with top-notch healthcare providers, Vida is breaking down the barriers that have historically kept people from getting the best care. It's trusted by Fortune 100 companies, major national payers and large providers to enable their employees to live their healthiest lives.

The Clinical Assistant manages and executes Vida’s end-to-end prescribing and prior authorization operations. This role is responsible for navigating complex Pharmacy Benefit Manager (PBM) criteria, handling complex member escalations, and ensuring members gain timely access to prescribed therapies.

We are seeking a proactive candidate with strong leadership capability—someone who demonstrates high autonomy, takes initiative to resolve complex issues, serves as an informal subject matter expert (SME) and mentor to peers, and proactively identifies ways to streamline and complete prior authorization workflows.

This is a 3 month seasonal position with possibility of extensions based on performance and business needs.

 

Responsibilities:

• Prepare, review, and submit accurate, clinical prior authorization requests to PBMs and health plans for anti-obesity medications.
• Autonomously manage complex exception processes and formulary overrides.
• Act as a key escalation point to research, troubleshoot, and resolve complex coverage inquiries coming from Medical Providers, Member Services, Quality Assurance, and Client Success teams.
• Serve as a knowledgeable liaison between Clinical Sssistant team and PBM formulary details for operational applications; assist with training team members on complex prior authorization guidelines as needed.
• Assist Vida Medical Providers by reviewing and responding to medical provider chat messages.
• Triage messages to appropriate parties as needed.
• Drive timely issue resolution and maintain high standards of communication by adhering to key performance indicators (KPIs) for ticket handling and message reviews.
• Research and address prescribing-related escalations that come from Vida Member Support, Vida Quality Assurance, Medical Providers, and Client Success.