Clinical Assistant

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.

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. Vida is proud to be an Equal Employment Opportunity and Affirmative Action employer.   Diversity is more than a commitment at Vida—it is the foundation of what we do. All qualified applicants will receive consideration for employment without regard to race, color, ancestry, religion, gender, gender identity or expression, sexual orientation, marital status, national origin, genetics, disability, age, or Veteran status. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.   We seek to recruit, develop and retain the most talented people from a diverse candidate pool. We don’t just accept differences — we celebrate them, we support them, and we thrive on them for the benefit of our employees, our platform and those we serve. Vida is committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures.   We do not accept unsolicited assistance from any headhunters or recruitment firms for any of our job openings. All resumes or profiles submitted by search firms to any employee at Vida in any form without a valid, signed search agreement in place for the specific position will be deemed the sole property of Vida. No fee will be paid in the event the candidate is hired by Vida as a result of the unsolicited referral.   **Vida is authorized to do business in many, but not all, states. If you are not located in or able to work from a state where Vida is registered, you will not be eligible for employment. Please speak with your recruiter to learn more about where Vida is registered.   Please note: Applicants must be authorized to work in the U.S. as Vida is unable to sponsor work visas for any position. All Vida Employees must reside in/be able to work from the U.S.- international work is prohibited. Job postings at Vida will remain open through end of year, until filled.   #LI-remote

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 Assistant 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.

Demonstrate strong self-leadership by managing daily workload priorities, monitoring queues, and driving timely turnarounds to maintain team SLAs.

Partner closely across multi-disciplinary care teams to align on member prescribing plans and medication access status.

Maintain strict confidentiality and adhere diligently to HIPAA guidelines regarding Protected Health Information (PHI).

Efficiently leverage Zendesk ticketing workflows, internal tools, and communication templates.

Accurately document all hours worked utilizing designated ADP pay codes.

Perform according to Vida’s QA, compliance, and clinical protocol guidelines.

Limit scope of practice to Vida clinical and organizational guidelines.

Perform other clinical support and operational duties as assigned.

Qualifications:

Preferred: