Prior Authorization Manager
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Prior Authorization Manager overseeing medication approvals and compliance for Polaris Pharmacy Services, an independent pharmacy-services provider. Leading teams, optimizing workflows, and coordinating with providers and insurers.
Responsibilities:
- Lead and manage the prior authorization team, providing guidance, support, and training
- Develop and implement policies and procedures to streamline the prior authorization process
- Ensure compliance with regulatory requirements and industry best practices
- Monitor and analyze prior authorization metrics
- Identify areas for improvement and implement efficiency and accuracy strategies
- Collaborate with healthcare providers, insurance companies, and internal departments
- Resolve issues and facilitate approval of medication requests
- Maintain current knowledge of healthcare regulations, insurance policies, and medication formularies
- Prepare and present reports on prior authorization activities, performance metrics, and improvement initiatives to senior management
- Foster a positive and collaborative work environment
- Promote teamwork and effective communication within the prior authorization team and across the organization
Requirements:
- Bachelor's degree in Healthcare Administration, Pharmacy, Business Administration, or a related field
- Minimum of 5 years of experience in a healthcare setting
- At least 3 years in a managerial or supervisory role
- Proven experience in prior authorization processes within a pharmacy or healthcare environment
- Demonstrated experience in process improvement and efficiency optimization in healthcare operations
- Strong knowledge of healthcare regulations and compliance related to prior authorizations
- Excellent leadership and team management skills
- Proficiency in data analysis and reporting
- Exceptional communication and interpersonal skills
- Ability to manage multiple priorities in a fast-paced environment
- Strong organizational skills
- Proficiency in pharmacy management software and relevant healthcare information systems
- May lift and/or move up to 30 pounds
- May be necessary to work extended hours as needed
Benefits:
- Competitive pay
- Robust benefits
- Paid holidays: 6 days annually
- 5 sick days annually
- Up to 10 PTO days annually, with rollover options and milestone bonuses
- Option to cash out up to 10 PTO hours each quarter
- Medical insurance
- Dental insurance
- Vision insurance
- 401(k), available for part-time and full-time employees
- Company-paid life insurance
- Short-term disability insurance
- Long-term disability insurance
- Tuition reimbursement
- Competitive pay with annual performance reviews and merit-based raises
- Career growth potential
- Annual on-site voluntary flu vaccines
- Employee referral bonus program
Similar Jobs
Regional Manager
Regional Manager generating mutual-fund sales among the American Muslim Community for Saturna Capital’s Islamic-finance investment business. Managing DFW relationships, client AUM growth, financial planning, and regional travel.
Manager, Network Management – Performance
Provider network manager leading recruitment, retention, contracting, and fee schedules for Liberty Dental Plan’s dental networks. Managing staff and cross-functional provider operations.
Onboarding Team Manager
Onboarding Team Manager leading client transitions to NetCov’s managed IT and cybersecurity platform. Managing onboarding specialists, integrations, project delivery, escalations, and client success.
Senior Manager – Front Office Solutions
Senior IT manager leading CAA’s customer-facing Salesforce, CRM, portals, and digital platforms. Driving strategy, delivery, operations, and engineering leadership across front-office technology.
Onboarding Team Manager
Onboarding Team Manager leading client transitions onto NetCov’s managed IT and cybersecurity platform. Managing specialists, integrations, project delivery, escalations, and client success.
Senior Manager – Front Office Solutions
Senior manager leading CAA's front-office technology strategy, Salesforce ecosystem, and customer-facing platforms. Driving enterprise delivery, operations, and engineering teams across transportation and logistics solutions.
Website Performance Manager
Website Performance Manager owning website relationships for Team Velocity, a full-service automotive marketing agency. Improving dealership site performance, retention, reporting, and application growth.
Website Performance Manager
Website Performance Manager owning dealership website relationships for Team Velocity, an automotive marketing agency. Driving retention, reporting, product enhancements, and portfolio growth.
Website Performance Manager
Website Performance Manager owning website relationships for automotive dealerships at Team Velocity, a full-service automotive marketing agency. Driving retention, reporting, enhancements, and portfolio growth.
Website Performance Manager
Website Performance Manager owning client relationships and optimizing website performance for Team Velocity, a full-service automotive marketing agency. Driving retention, reporting, enhancements, and portfolio growth.
Website Performance Manager
Website Performance Manager owning automotive dealership website relationships for Team Velocity, a full-service automotive marketing agency. Driving retention, reporting, enhancements, and portfolio growth.
Website Performance Manager
Website Performance Manager managing automotive dealership website relationships for Team Velocity, a full-service automotive marketing agency. Driving retention, reporting, issue resolution, and portfolio growth.
Website Performance Manager
Website Performance Manager owning website relationships for automotive dealerships at Team Velocity, a full-service automotive marketing agency. Driving retention, reporting, issue resolution, and portfolio growth.
Website Performance Manager
Website Performance Manager owning client relationships and improving automotive dealership websites for Team Velocity, a full-service automotive marketing agency. Driving retention, analytics, SEO, support, and portfolio growth.
Website Performance Manager
Website Performance Manager owning automotive dealership website relationships for Team Velocity, a full-service automotive marketing agency. Driving retention, reporting, product enhancements, and portfolio growth.
Website Performance Manager
Website Performance Manager owning automotive dealership website relationships for Team Velocity, a full-service automotive marketing agency. Driving retention, analytics, product enhancements, and portfolio growth.
Website Performance Manager
Website Performance Manager owning automotive dealership website relationships for Team Velocity, a full-service automotive marketing agency. Driving retention, analytics, support, and website growth opportunities.
Website Performance Manager
Website Performance Manager owning automotive dealership website relationships for Team Velocity, a full-service automotive marketing agency. Driving retention, reporting, growth, and website performance enhancements.
Area Manager – Final Mile
Area Manager leading Evri’s East-region final-mile delivery operations across logistics and distribution. Driving transformation, performance, compliance, customer experience, P&L, and people leadership.
Manager, Workforce Management
Workforce Management Manager optimizing call center staffing, forecasting, and service levels. Leading analysts, managing WFM platforms, and driving audit-ready operational performance.