Current jobs related to Director, Prior Authorization Center - Kennedy Space Center - EmpiRx Health

  • Authorization and Utilization Management Specialist

    4 weeks ago

    Kennedy Space Center, United States Centene Corporation Full time

    Job SummaryAs an Authorization Specialist I at Centene Corporation, you will play a critical role in supporting the prior authorization request process to ensure timely and accurate documentation. This position requires strong analytical and communication skills to effectively collaborate with the utilization management team.Key ResponsibilitiesPrior...

  • Authorization Specialist I

    3 weeks ago

    Kennedy Space Center, United States Centene Corporation Full time

    Job Summary:At Centene Corporation, we are seeking a highly skilled Authorization Specialist I to join our team. As a key member of our utilization management team, you will play a critical role in ensuring that all authorization requests are addressed properly and in a timely manner.Key Responsibilities:Support the prior authorization process to ensure all...

  • Medical Authorization Specialist

    1 week ago

    Clay Center, United States Clay County Medical Center Full time

    Prior Authorization SpecialistClay County Medical Center is seeking a skilled Prior Authorization Specialist to join our team. As a key member of our healthcare team, you will be responsible for ensuring that patient services are properly authorized and approved.Key Responsibilities:Monitor schedules and identify patient services requiring prior...

  • Wound Care Center Clinical Coordinator

    2 weeks ago

    Kennedy Space Center, United States Healogics Full time

    Job SummaryWe are seeking a highly skilled and experienced Clinical Nurse Manager to join our team at Healogics. As a Clinical Nurse Manager, you will be responsible for coordinating clinical activities, patient care assessment, and quality improvement initiatives in our Wound Care Center.Key ResponsibilitiesCollaborate with the Program Director and Medical...

  • Wound Care Center Clinical Coordinator

    1 week ago

    Kennedy Space Center, United States Healogics Full time

    Job SummaryWe are seeking a highly skilled and experienced RN Care Coordinator to join our team at Healogics. As a Clinical Coordinator, you will play a critical role in the coordination of clinical activities of the Wound Care Center, ensuring optimal healing outcomes and patient satisfaction.Key ResponsibilitiesCoordinate patient care activities, including...

  • Wound Care Center Clinical Coordinator

    6 days ago

    Kennedy Space Center, United States Healogics Full time

    Job Title: Clinical Coordinator (CC)/Clinical Nurse Manager (CNM)The Clinical Coordinator (CC)/Clinical Nurse Manager (CNM) plays a vital role in the coordination of clinical activities at the Wound Care Center. This position is responsible for patient care assessment, patient care planning and implementation, and working on patient care quality improvement...

  • Sales Director

    2 weeks ago

    Kennedy Space Center, United States NVR Full time

    Job SummaryNVR, a leading homebuilder in the US, is seeking a highly skilled Sales Director to manage all sales activity for a homebuilding profit center. As a key member of our team, you will be responsible for developing and executing sales strategies to achieve monthly and annual sales plans.Key ResponsibilitiesLead Sales Team: Directly manage a team of...

  • Sales Director

    2 weeks ago

    Kennedy Space Center, United States International Diamond Center Full time

    {"title": "Sales Manager Position", "description": "About Us: International Diamond Center is a leading retailer in the fine jewelry industry, committed to delivering exceptional customer service and high-quality jewelry. We are seeking a skilled Sales Manager to drive our sales team's performance and contribute to our company's success. Job...

  • In Office Call Center Representative

    2 months ago

    Kennedy Space Center, United States Hilton Grand Vacations Full time

    Job Description Hilton Grand Vacations is proud to have a team with diverse abilities that mirror the variety of vacations we offer. We are dedicated to creating a work environment that cultivates growth, allowing our team members to not only improve their existing skills but also acquire new ones to advance their careers. If you are ready to take your...

  • Regional Director

    4 days ago

    Kennedy Space Center, United States The Learning Experience Full time

    Job Title: Regional ManagerJoin The Learning Experience team as a Regional Manager and take on a challenging role that requires strong leadership and operational skills. As a Regional Manager, you will be responsible for overseeing multiple locations, driving business growth, and ensuring exceptional customer experiences.Key Responsibilities:Lead and manage...

  • Wound Care Clinical Coordinator

    2 weeks ago

    Kennedy Space Center, United States Healogics Full time

    Job Title: Clinical Nurse Manager - Wound Care CenterHealogics, the largest provider of advanced wound care services in the United States, is seeking a highly skilled Clinical Nurse Manager to join our team. As a Clinical Nurse Manager, you will be responsible for coordinating clinical activities of the Wound Care Center, including patient care assessment,...

  • RN Care Coordinator

    3 weeks ago

    Kennedy Space Center, United States Healogics Full time

    Job SummaryWe are seeking a highly skilled and experienced Clinical Nurse Manager to join our team at Healogics. As a key member of our clinical staff, you will be responsible for coordinating clinical activities, patient care assessment, and quality improvement initiatives.Key ResponsibilitiesCoordinate clinical activities, including patient care...

  • Director of Guest Services and Operations

    3 weeks ago

    Kennedy Space Center, United States Wyndham Hotels & Resorts Full time

    Job SummaryThe Director of Guest Services and Operations is responsible for ensuring the smooth operation of guest services, concierge, and uniformed services/transportation in a professional and courteous manner, providing all guests with exceptional service prior to and throughout their stay, while maximizing room revenue and occupancy.Key...

  • Business Development Center Sales Coordinator

    3 days ago

    Kennedy Space Center, United States Universal Heliair, Inc Full time

    Job Title: Business Development Center Sales CoordinatorUniversal Heliair, Inc is seeking a highly motivated and organized Business Development Center Sales Coordinator to join our team. As a key member of our sales team, you will be responsible for handling all incoming phone calls and internet leads, confirming sales appointments, and performing long-term...

  • Director of Guest Services

    1 week ago

    Kennedy Space Center, United States Wyndham Hotels & Resorts Full time

    Director of Guest ServicesWyndham Hotels & Resorts is seeking a highly skilled and experienced Director of Guest Services to join our team at the Wyndham Orlando Resort in Orlando, Florida.Job Summary:The Director of Guest Services is responsible for ensuring the operation of guest services, concierge, and uniformed services/transportation in an attentive,...

  • Regional Sales Director

    3 weeks ago

    Kennedy Space Center, United States Tesla Full time

    About the RoleAs a Regional Sales Manager at Tesla, you will play a pivotal and multifaceted role in steering the success of operations across a designated territory. Your core responsibility is to drive revenue and deliver exceptional customer experiences while shaping the long-term strategic direction of the region.Key ResponsibilitiesLeadership and Team...

  • Senior Financial Analyst

    1 month ago

    Kennedy Space Center, United States University of Central Florida Full time

    Position Overview: The Finance Business Center at UCF is seeking qualified candidates for the role of Finance/Budget Analyst III. This role involves the management of financial transactions within the university's financial systems. The Analyst will be responsible for gathering, evaluating, and reconciling financial data, transactions, and budgets....

  • Director of Guest Services

    3 months ago

    Kennedy Space Center, United States Wyndham Hotels & Resorts Full time

    Location: Orlando, FL, US Wyndham is now seeking a Director of Guest Services to join our team at the Wyndham Orlando Resort location in Orlando , Florida .**Job Summary** The Director of Guest Services is responsible for ensuring the operation of guest services, concierge and uniformed services/transportation in an attentive, friendly, efficient and...

  • Healthcare Access Coordinator

    1 month ago

    Kennedy Space Center, United States The Staffing Resource Group Inc Full time

    Position Overview:As a Healthcare Access Coordinator, you will play a vital role in facilitating patient access to essential medications and therapies. Key Responsibilities:In this position, you will collaborate closely with healthcare providers and insurance entities to collect pertinent information regarding patients' insurance coverage for specific...

  • Pre-Authorization Specialist

    2 weeks ago

    Valley Center, Kansas, United States Bryan Health Full time

    Job SummaryThe Bryan Health Pre-Authorization Specialist plays a crucial role in ensuring that patients receive the necessary medical services by verifying demographic and insurance information, obtaining prior authorization, and resolving any issues that may arise. This position requires strong problem-solving skills, attention to detail, and effective...

Director, Prior Authorization Center

3 months ago

Kennedy Space Center, United States EmpiRx Health Full time
Who We Are:

EmpiRx Health is the leading clinically-driven, customer-first PBM company that puts the pharmacist at the center of its service model to optimize member care while substantially reducing costs for plan sponsors.

What We Do:

We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we do-and our population health solution delivers tailored strategies for our clients.

Who We're Looking For:

EmpiRx Health is experiencing unprecedented growth, and we're seeking a highly skilled and experienced Director, Prior Authorization Center. As the Director, Prior Authorization Center, you will be a subject matter expert accountable for leading a team of Prior Authorization Pharmacists and Technicians dedicated to the prior authorization and appeals processes. The Director of Prior Authorization Center will create and maintain policies and procedures for utilization management review, optimize staffing workflow, analyze performance trends, generate comprehensive reports on prior authorization/appeal metrics, and lead the recruitment and onboarding process for pharmacist and technicians.

If you are a highly motivated Director, Prior Authorization Center with a strong background in prior authorizations and appeals, and you are passionate about making a meaningful impact in the healthcare industry, we encourage you to apply.

What You'll Do:

As a Director, Prior Authorization Center, your role will encompass a wide range of responsibilities:
  • Manage a team to ensure a positive team environment, conduct performance review and provide feedback and opportunities for development.
  • Work with VP of Clinical Operations to develop and implement strategic initiatives to improve the overall effectiveness of the prior authorization services.
  • Develop and implement policies and procedures ensuring compliance with federal, state, and local guidelines.
  • Educate team on relevant changes and developments.
  • Assist with clinical audits, including documentation preparation.
  • Participate in continuous quality improvement efforts to streamline the clinical review process and enhance member care.
  • Monitor and identify performance trends while ensuring timely and cost-effective delivery of care.
  • Ensure that all staff comprehend and comply with professional standards and internal process and procedures.
  • Generate and deliver prior authorization/appeal reports to both internal and external stakeholders.
  • Monitor quality measures ensuring accuracy to guidelines.
  • Monitor, investigate, and resolve escalated issues related to prior authorization while maintaining a high level of members/provider/clients' satisfaction.
  • Stay updated with changes in pharmacy practice, and industry regulations through continuing education and professional development.
  • Stay informed about EmpiRx Health formulary changes, clinical programs, and internal policies.
  • Support staff training and development.
  • Proficiently utilize pharmacy management software for documentation and communications.
  • Proficiently Utilize EmpiRx Health internal tools for team's oversight and monitoring (e.g., DOMO, SalesForce) •Proficiently utilize Microsoft Office tools.
  • Utilize external clinical and drug information tools to support clinical reviews and decision making as well as to stay abreast of current drug pipeline (e.g., IPD, Policy Reporter, UpToDate and MediSpan).
  • Collaborate with cross functional teams to offer clinical support/ guidance while delivering best in class services to our members and clients.
What You Need:
  • Bachelor of Pharmacy
  • Active pharmacist license
  • 5+ years of prior authorization experience at health plan and/or PBM.
  • 10+ years of management experience required.
  • Exceptional written/verbal communication skills and interpersonal skills
  • Experienced in Microsoft Office Suite, prescription medication analysis.
  • Ability to work in a fast-paced place with shifting priorities.
  • Ability to work independently and make clinical decisions.
  • Must demonstrate professional practices and adherence to company standards.
  • PharmD preferred
  • MTM certification, or other specialty certification preferred


Why Join Us:
  • EmpiRx Health is on an extraordinary journey where excellence meets innovation.
  • Availability to work 5 days onsite
  • We are a collaborative team that encourages groundbreaking ideas, values open dialogue, and prioritizes continuous improvement.
  • You will be part of a dynamic team where success is a shared celebration, collaboration fuels progress, and we redefine healthcare together.
  • We offer a generous and competitive benefits package.
  • You will share in the company's success through our discretionary bonus program.
EmpiRx Health is an Equal Opportunity Employer

At EmpiRx Health, we wholeheartedly embrace the power of diversity and the magic of inclusion. The kaleidoscope of unique perspectives, backgrounds, and talents fuels our innovation and sets us apart. We're not just breaking down barriers but actively erasing them to create an environment where opportunity knows no bounds. In unity, we find our strength and invite individuals from all walks of life to join us in our exhilarating journey to shape a brighter, more inclusive future together.

Your career at EmpiRx Health awaits - join us in shaping the future of excellence in healthcare.
Careers - EmpiRx Health

**No recruiters, please**