Hybrid Manager, Pharmacy Clinical Operations – Prior Authorization

Posted last week

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About the role

  • Manager of Pharmacy Clinical Operations developing clinical programs at Elevance Health. Leading pharmacy operations and ensuring quality drug utilization and compliance for clients.

Responsibilities

  • 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

Job title

Manager, Pharmacy Clinical Operations – Prior Authorization

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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