Vida Health

Personalized digital health care with pay-for-performance

Clinical Assistant

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeRemote in USA$26.04 /hr

About the Job

Requirements

At least 3 years of experience focused on prior authorizations or pharmacy benefit manager navigation within a medical clinic, specialty pharmacy, health plan, or telehealth environment.
A proven track record of taking initiative, leading projects or workflow improvements, and mentoring or guiding colleagues without formal direct-report management.
Deep knowledge of prior authorization submission criteria, pharmacy benefit manager formulary exception workflows, prescribing protocols, and clinical documentation for cardiometabolic or specialty drugs.
Excellent written and verbal communication skills, with the ability to resolve cross-departmental escalations diplomatically.
Proficiency with electronic health record tools, prior authorization platforms such as CoverMyMeds, and cloud collaboration tools such as Google Suite and Slack.
Strong organization, time-management, and analytical skills, with the ability to work independently in a fast-paced environment.
Availability to work Monday through Friday during standard business hours between 8:00 AM and 8:00 PM in the candidate’s local time zone.
Must be authorized to work in the United States; work visas are not sponsored.
Must reside in or be able to work from the United States, and international work is prohibited.
Must be located in or able to work from a state where Vida is registered.
Preferred: Certified Medical Assistant or related healthcare certification.
Preferred: Previous experience in virtual care, digital health, or a high-growth startup setting.
Preferred: Proficiency with telehealth technology.
Preferred: Ability to multitask and prioritize in a fast-paced environment.
Preferred: Compassionate and patient-centered approach to care.
Preferred: Strong organizational skills and attention to detail.

Responsibilities

Prepare, review, and submit accurate clinical prior authorization requests to pharmacy benefit managers and health plans for anti-obesity medications.
Manage complex exception processes and formulary overrides autonomously.
Research, troubleshoot, and resolve complex coverage inquiries escalated by medical providers, member services, quality assurance, and client success teams.
Act as a liaison between the Clinical Assistant team and pharmacy benefit manager formulary details for operational applications, and 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.
Meet key performance indicators for ticket handling and message reviews to support timely issue resolution and high communication standards.
Research and address prescribing-related escalations from Vida Member Support, Vida Quality Assurance, Medical Providers, and Client Success.
Manage daily workload priorities, monitor queues, and drive timely turnarounds to maintain team service-level agreements.
Partner with multidisciplinary care teams to align member prescribing plans and medication access status.
Maintain confidentiality and comply with HIPAA guidelines regarding protected health information.
Use Zendesk ticketing workflows, internal tools, and communication templates efficiently.
Document all hours worked using designated ADP pay codes.
Follow Vida’s quality assurance, compliance, and clinical protocol guidelines.
Limit scope of practice to Vida clinical and organizational guidelines.
Perform other assigned clinical support and operational duties.

Desired Qualifications

Previous experience in virtual care, digital health, or a high-growth startup setting.
Proficiency with telehealth technology.
Ability to multitask and prioritize in a fast-paced environment.
Compassionate and patient-centered approach to care.
Strong organizational skills and attention to detail.

Salary Range: 26.04 to 26.04 (Currency: USD) (Pay period: per-hour-wage)

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.

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.

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:

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 without requiring formal direct report management.

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:

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.

Ability to multitask and prioritize in a fast-paced environment.

Compassionate and patient-centered approach to care.

Strong organizational skills and attention to detail.

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

About the Company

Vida Health

Personalized digital health care with pay-for-performance

Vida Health provides personalized health programs for conditions like diabetes, obesity, depression, and hypertension, serving individuals and employers. It blends human-centered care with technology by pairing live video sessions with registered dietitians, prescribing physicians, coaches, and licensed therapists with customized digital interventions and educational content. The platform uses machine learning to tailor each member’s journey using data from connected devices such as continuous glucose monitors, scales, and fitness trackers. A key differentiator is its pay-for-performance model, where up to 100% of fees are at risk if outcomes aren’t achieved, aligning incentives around real health improvements. The company’s goal is to deliver measurable health benefits—improving medication adherence, promoting weight loss, and reducing depression—while reducing overall healthcare costs for individuals and enterprise clients.

Company size: 501-1,000
Company stage: Late Stage VC
Total funding: $216.5M
Headquarters: San Francisco, CA
Founded: 2014

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