PRN Clinical Assistant

Job Details: Job Location: Corporate - Nashville, TN, Salary Range: Undisclosed,

General Purpose:

The PRN Clinical Assistant supports preventive care, medication optimization, quality improvement, and population health initiatives through member, provider, pharmacy, and ancillary outreach, documentation retrieval, appointment coordination, and follow-up activities.

Essential Duties & Responsibilities:

Member Outreach & Care Coordination

Conduct outbound calls to members/providers identified for care coordination support.
Assist members with:

Scheduling bone density scans (BDS/DEXA) and other preventive appointments as directed.
Providing appointment reminders and follow-up calls to confirm completion.
Coordinating with imaging centers to obtain test results and documentation.
Identifying and documenting non-clinical barriers to care (e.g., transportation, scheduling conflicts, access issues).
Providing information on available benefits or resources to help address identified barriers, within scope of practice.
Escalating clinical questions or complex concerns to licensed clinical staff per established protocols.

Document member-reported concerns and escalate clinical questions to licensed staff (RN/LPN/Pharmacist) per protocol.
Provide standardized, call guide-based education approved by clinical leadership.
Medication Optimization Support

Support medication-related outreach initiatives including adherence, medication optimization, safety, and preventive quality programs.
Conduct outbound calls to provider offices, pharmacies, and ancillary partners regarding medication-related interventions.
Assist with obtaining documentation, medication-related records, and provider responses through phone, fax, electronic communication, and other approved channels.
Relay standardized, pre-approved clinical messaging and documentation requests.
Support workflows related to:

Contraindications
Missing or suboptimal therapy opportunities
Medication not indicated
Drug interactions
Duplicate therapy
High dosage alerts
Potential adverse drug reactions
Cost-savings opportunities

Assist with status updates from provider offices and pharmacies.
Track intervention outcomes and document outreach activities in designated systems.
Escalate clinical questions or medication-related concerns to licensed clinical staff per protocol.

Provider & Ancillary Services Coordination

Contact provider offices to confirm bone density scan (BDS/DEXA) orders, appointment dates.
Request and obtain completed imaging reports per established protocols.
Follow up on outstanding documentation to ensure timely receipt and closure of care gaps.
Coordinate with imaging centers to confirm appointment status and retrieve completed scan results.
Relay standardized, pre-approved communications when required.
Maintain professional and respectful relationships with external offices and imaging partners.

Administrative Support

Accurately document all outreach attempts, scheduling updates, and documentation status in designated systems.
Track pending appointments, incomplete scans, and outstanding records to ensure timely follow-up.
Meet established productivity and quality benchmarks for outreach and documentation accuracy.
Escalate clinical questions or documentation discrepancies to licensed staff per protocol.
Support workflow improvements and process optimization initiatives as directed by leadership.

Education & Experience:

One of the following required:

Certified or Registered Medical Assistant (CMA/RMA)
Certified Pharmacy Technician (CPht)
Pharmacy Intern in good standing with an accredited College of Pharmacy and experience w/ provider outreach

Minimum 1 year of experience in a clinical back-office setting preferred.
Experience communicating with provider offices, pharmacies, or ancillary healthcare partners preferred.
Experience with medication adherence, medication therapy management (MTM), prior authorizations, refill coordination, or quality initiatives preferred.
Experience coordinating referrals, imaging, or specialty appointments preferred.
Experience requesting and obtaining medical records, imaging reports, or other clinical documentation from provider offices, pharmacies, or ancillary facilities preferred.
Experience tracking and obtaining diagnostic test results (e.g., imaging, labs) preferred.

Familiarity with bone density scan (BDS/DEXA) coordination, preventive screenings, or care gap closure initiatives preferred. Experience conducting outbound reminder calls and follow-up outreach preferred.

Experience working in a metrics-driven, call-based, or population health environment preferred.
Experience with Medicare Part D, medication adherence, medication quality measures, or population health programs preferred.
Experience reviewing, supporting, or documenting medication-related interventions such as adherence opportunities, medication safety concerns, therapy optimization opportunities, duplicate therapy, drug interactions, or contraindications a plus.
Experience supporting provider outreach, pharmacy support workflows, or clinical optimization initiatives strongly preferred
Prior experience in care coordination, clinical support, call center operations, pharmacy support, or population health preferred.
Experience supporting prior authorization, referral management, or medical records workflows preferred.
Experience in provider outreach, care gap closure, medication-related quality initiatives, or clinical quality improvement programs strongly preferred.
Proficiency with call center phone systems and outbound dialer technologies, and web-based documentation platforms preferred.
Proficient in Microsoft Office applications

Skills & Competencies

Familiarity with pharmacy and medical terminology and medication names preferred.
Ability to communicate professionally with provider offices and pharmacies regarding medication-related workflows.Ability to follow structured call guides  and workflows.
Excellent documentation skills and attention to detail.
Strong organizational and time-management skills.
Comfortable working within standardized clinical protocols and escalation pathways.
Ability to manage multiple outreach queues and follow-up tasks simultaneously.
Proficient in Microsoft Office and web-based systems.

Minimum Physical Requirement:

The PRN Clinical Assistant will perform his or her work both in a remote, secure home environment and in a general office environment using standard office equipment.  The following demands are representative of those that must be met by an employee to successfully perform the essential functions of this job:

Regularly lift and/or move up to 10 pounds
Bend, twist or stoop on a repetitive and continuous basis
Stand and remain on feet for extended periods of time
Operate various business instruments, including computers, printers/scanners/fax machines, requiring manual dexterity
Sit and concentrate for long periods of time to compute, examine, and interpret data
Read paperwork and computer monitors, requiring visual acuity

Skills:

Strong interpersonal and communication skills with the ability to build rapport with members, provider offices, and pharmacies.
Professional phone etiquette with confidence conducting outbound outreach calls.
Ability to follow structured scripts, workflows, and standard operating procedures.
Strong organization time-management skills with the ability to manage multiple follow-up tasks.
Detail-oriented with accurate and timely documentation skills.
Ability to identify non-clinical barriers (transportation, access, scheduling) and escalate clinical concerns appropriately.
Comfortable working in a fast-paced, metrics-driven environment.
Ability to adapt to process updates and workflow changes.
Basic understanding of medical terminology.
Proficiency in Microsoft Office and web-based documentation systems.
Demonstrates sound judgment within scope of defined role and supervision structure.

Qualifications: