POSITION SUMMARYThe Clinical Administrator is responsible for managing the day-to-day functioning of the myMatrixx clinical department. Work closely with pharmacist staff to coordinate clinical interventions. Duties include ensuring optimal client services, communicating with different departments, outreaching to prescribers offices, participating in periodic meetings, helping with assignment of interventions, measuring and reporting outcomes.Primary Functions
Delivers specific delegated clinical tasks assigned by a supervisor
Receives requests by email, telephone, fax regarding clinical interventions
Responds to inquiries from adjusters, different departments and/or others for information and assistance
Sorts progress notes and clinical documents to initiate interventions for pharmacy reviews
Manages interventions utilizing MS software, myMatrixx portals and systems
Completes day-to-day tasks under minimal supervision, but ready access to advice from more experienced team members
Tasks involve a degree of forward planning and anticipation of needs to resolve issues
Key Qualifications
High school diploma or GED
At least 1 year of workers comp claims experience
Proficient data entry skills
Clinical administrative / medical office experience preferred
Experience in managed care or pharmacy technician helpful
Knowledge of myMatrixx systems
Excellent communication (oral and written) and interpersonal skills
Ability to understand and interpret client requests to independently respond to inquiries, grievances or complaints of moderate to substantial complexity.
Proficient using Excel, Word, Outlook, Fax,
Ability to quickly learn new portals and systems, navigate the Internet
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.About Evernorth Health ServicesEvernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.Qualified applicants with criminal histories will be considered for employment in a mannerconsistent with all federal, state and local ordinances.The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Full-time- ID: #52714376
- State: Florida Tallahassee 32318 Tallahassee USA
- City: Tallahassee
- Salary: USD TBD TBD
- Showed: 2024-10-16
- Deadline: 2024-12-15
- Category: Et cetera