Manager, Pharmacy Clinical Operations – Prior Authorization

Role Overview

• Assists in the development of new clinical products
• Oversees the Prior Authorization Center
• Implements new prior authorization program
• Manages clinical pharmacy operations and staff to ensure clients' objectives and deliverables are met
• Oversees departmental processes, policies and procedures, training, and communication
• Reports and analyzes prior authorization program trends
• Ensures achievement of department goals and objectives
• Hires, trains, coaches, counsels, and evaluates performance of direct reports
• Provides clinical consulting services to client and implements clinical information and education programs
• Assists in developing formularies
• Performs drug utilization analyses
• Participates in and presents to Pharmacy and Therapeutics (P&T) committee meetings and management of client formulary

Requirements

• Requires BA/BS in Pharmacy
• Minimum of 4 years of experience as a pharmacist in a clinical setting
• Requires a registered pharmacist
• Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh)
• Medicaid and Commercial prior authorization reviewing experience preferred
• Experience optimizing PA intake, review, and follow-up workflows to reduce turnaround time and rework preferred
• Ability to work effectively on cross-functional teams and values shared accountability/collective success preferred
• Demonstrated ability to lead teams effectively, including coaching, performance management, and employee engagement preferred
• Experience with medical injectables preferred
• Experience with PA Hub preferred

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs (unless covered by a collective bargaining agreement)
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources