Specialist III, Prior Authorization
About the Opportunity
The SPECIALIST III, PRIOR AUTHORIZATION leads the daily operations of the prior authorization team, ensuring efficient coordination and support to meet team goals for performance, provider and patient satisfaction, and process improvements. This role serves as a subject matter expert and coach, contributing to the success of the prior authorization function and facilitating effective communication and problem resolution.
About Our Client
The organization operates within the specialty pharmacy sector, addressing the complex process of prior authorizations required for patient medication access. It focuses on streamlining interactions between providers, insurance companies, and patients to improve healthcare outcomes through efficient prior authorization management.
Responsibilities
- Lead and support the prior authorization team to maintain a positive and productive environment
- Assign daily tasks and provide guidance for complex problem-solving
- Train new and existing team members on core responsibilities and tools
- Identify and recommend workflow and process improvements
- Support associates with protocol understanding and operational questions
- Assist with prior authorization workflow, including phone and work queue management
- Participate in compliance and diversity, equity, and inclusion initiatives
- Perform other related duties as assigned
Requirements
- High School diploma or GED
- National CPhT certification and/or state-required registration/licensure
- Minimum 2 years of pharmacy support or healthcare environment experience
- Commitment to compliance program objectives
- Ability to interact cooperatively and respectfully with colleagues
Pay
USD 21.05 to USD 25.06 per hour
Benefits
- Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401(k) company match up to 5% with no vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program up to $750