Clinical Assistant - Vida Health

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.

The Role

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.

Note: This is a 3-month seasonal position with the 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 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 and triage messages to appropriate parties.
• 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 from Vida Member Support, 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.

Qualifications

• 3+ years of experience focused on prior authorizations or PBM navigation within a medical clinic, specialty pharmacy, health plan, or telehealth environment.
• Proven track record of taking initiative, leading projects or workflow improvements, and mentoring or guiding colleagues.
• Deep knowledge of prior authorization submission criteria, PBM formulary exception workflows, navigating prescribing protocols, and clinical documentation for cardiometabolic/specialty drugs.
• Excellent written and verbal communication skills with a proven ability to resolve cross-departmental escalations diplomatically.
• Proficiency in electronic health record (EHR) tools, prior authorization platforms (e.g., CoverMyMeds), and cloud collaboration tools (Google Suite, Slack).
• Strong organization, time-management, and analytical skills with the ability to operate independently in a fast-paced environment.
• Able to work within standard business hours supporting operational needs Monday through Friday between 8:00 AM – 8:00 PM (in candidate’s local time zone).

Preferred Qualifications

• Certified Medical Assistant (CMA) or related healthcare certification.
• Previous experience in a virtual care, digital health, or high-growth startup setting.
• Proficiency in using telehealth technology.
• Compassionate and patient-centered approach to care.