Rph - Director - Prior Authorization Center - PBM - New Jersey

1 week ago


Westwood, United States Tandym Group Full time

A pharmacy benefits management solution company in New Jersey is seeking an experienced Pharmacy Director of Prior Authorization Center.

About the Opportunity:

  • Schedule: Monday - Friday
  • Hours: Days (anything applicable that the candidate should know before applying)
  • Setting: Hybrid or Remote
Responsibilities:

The Pharmacy Director - Prior Authorization Center will be responsible for:
  • Expert accountable for leading a team of Prior Authorization Pharmacists and Technicians dedicated to the prior authorization and appeals processes.
  • 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
  • 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
Qualifications:
  • 5+ years of Management experience
  • 5+ years of prior authorization experience at health plan and/or PBM
  • PharmD (required)
  • Active Pharmacist license
  • 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
  • Active pharmacist license.
Desired Skills:
  • MTM certification, or other specialty certifications


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