Job Description
Responsibilities
- Directly manage, coach, and mentor a team of prior authorization Pharmacists
- Drive and maintain regulatory, compliance, and accreditation standards for the clinical review team
- Recruit, hire, and lead training and onboarding for new team members
- Manage team performance through the measurement of key performance indicators (KPIs)
- Provide day-to-day supervision, support, and escalation paths for Pharmacists
- Identify and drive operational process improvements to support business scaling
- Collaborate cross-functionally with departments regarding eligibility, claims, and benefit designs
- Participate in the Pharmacy and Therapeutics Committee process to develop clinical criteria for medications
- 5+ years of health plan or PBM experience, specifically in prior authorization review
- 3-5+ years of management experience
- Bachelor's degr...