Optician- Part -Time Casual (NC)

GDIT’s Non-Pharmacy Prior Approval (PA) review team is hiring a part-time Licensed Optician/Medical Affairs Analyst, to review and provide expert analysis of PA requests of visual aid services. Visual aid request submitted are from providers of services to North Carolina Medicaid beneficiaries. For this role, you must live in NC.

The Optician/Medical Affairs Analyst will be responsible for determining the medical necessity of requested services by following the North Carolina Division of Health Benefits Clinical Coverage Policy and by following GDIT contractual administrative services agreements. The GDIT contractual administrative services include representing PA denials in mediations and at Appeal Court Hearings.

Additional responsibilities will include communicating PA review data to the Division of Health Benefits and responding to Provider inquiries regarding optical services.

Drive better health outcomes for our clients as a Optician/Medical Affairs Analyst at GDIT. Here, your work will impact many as you deliver healthcare expertise and services where they are needed most.

HOW A OPTICIAN/MEDICAL AFFAIRS ANALYST WILL MAKE AN IMPACT

• Perform optical mediations for appealed prior authorizations on behalf of the client.
• Prior experience working in an Ophthalmologist or Optometrist office.
• Complete all work within all SLA requirements and timelines.
• Meet all quality and quantity benchmarks.
• Work with department leadership, State Stakeholders, Provider, and Beneficiaries
• Participate in workgroups that address both clinical and non-clinical internal activities

WHAT YOU’LL NEED TO SUCCEED:

• Must be a NC licensed Optician
• High school Diploma/ GED
• Required Experience: 5+ years of related experience
• Required Technical Skills: Knowledge of Microsoft word, excel, and other basic computer skills
• Required Skills and Abilities: Excellent communication and problem solving skills
• Location: Remote with onsite initial training
• US Citizenship Required