Manager, Pharmacy Clinical Operations – Prior Authorization
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Atlanta • Florida • Texas • United States
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About the role
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical product developmentprior authorization program implementationclinical pharmacy operations managementdrug utilization analysisformulary developmentclinical consultingperformance managementcoachingemployee engagementmedical injectables
Soft Skills
leadershipcommunicationteam collaborationaccountabilitycoachingperformance evaluationtraininganalytical skillsproblem-solvinginterpersonal skills
Certifications
BA/BS in PharmacyRegistered Pharmacist (RPh)active unrestricted state license