Base: $140,000 - $150,000 usd; bonus/equity: not s...
Remote
Prior authorization and appeals process
Utilization management review
Prior authorization staffing
Lead and nurture a dynamic team of clinical pharmacists and technicians dedicated to the prior authorization and appeals process
Job Summary
Lead and nurture a dynamic team of clinical pharmacists and technicians dedicated to the prior authorization and appeals process.
Supervise the UM quality management process to ensure compliance with state, federal, and regulatory guidelines.
Perform day to day clinical pharmacy functions including prior authorization and appeal reviews, override requests, and inbound and outbound member and provider education calls.
Matching Summary
Lead and nurture a dynamic team of clinical pharmacists and technicians dedicated to the prior authorization and appeals process.
Salary
Base: $140,000 - $150,000 USD; Bonus/Equity: Not specified; Benefits: Not specified
Skills & Requirements
Must-have
prior authorization and appeals process
utilization management review
prior authorization staffing
quality improvement committee
clinical criteria and decision tree creation
Nice-to-have
data-driven insights
enterprise health platform
rebuilding trust in healthcare
fast-paced environment
Key Requirements
Active, unrestricted, pharmacist license
Bachelor of Pharmacy or Doctorate of Pharmacy Degree
4+ years prior authorization experience
3+ years leadership experience preferred
Experience with Commercial and Medicare Part D preferred