Clinical Operations Specialist

The Clinical Operations Specialist supports the CPM organization operationally in order to allow the client facing CPM to become more strategic and CPM Analyst to focus on clinical tasks. The primary responsibility of the Clinical Operations Specialist will be to coordinate various operational/technical duties.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Assists with formulary prior authorization guideline and standard print operational/analytic support needs working with assigned client facing CPMs and CPM analysts. Serves as technical expert within this process and a resource for deliverable assistance;
• Supports various disruption reporting as needed to support CPMs;
• Provides skillful data analysis and consultation as needed using tools such as Microsoft Excel / Access SQL Visual Basic Tableau and proprietary database tools;
• Liaison to Benefits department as required;
• Understand client benefit structure and coding. Requires use of MedAccess at intermediate or expert level.
• Develops modifies and runs reports to facilitate CPM data analysis for a variety of purposes;
• Develops expertise with Cognos and have ability to consult with CPMs and assists with report development to support client consultation and run reports as needed for CPM;
• Assists with client/internal presentation preparations under the direction of a CPM;
• Collaborates to improve processes internally to streamline work and outcomes; assist with benefit needs as directed by CPM Leads;
• Assists CPMs with formatting of various UM documents as directed by CPMs;
• Online literature searches as needed by CPMs;
• Pull quarterly UM reports to assist CPMs;

Qualifications

• To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

• Associates degree minimum; 3-5 years experience and/or education in product support project coordination and/or business analysis in health care or related environment; or equivalent combination of education and experience.

Computer Skills

• To perform this job successfully an individual should have proficient knowledge of MS Office Suite including Excel and Access and established success in proprietary systems.

Certificates Licenses Registrations

• Pharmacy Technician license in good standing is desired but not required.