Pharmacy Prior Authorization Specialist

4 weeks ago

Fairhaven, Massachusetts, United States Southcoast Health System Full time
Job Summary

Southcoast Health System is seeking a skilled Pharmacy Prior Authorization Specialist to support our initiatives related to medication utilization and coverage. As a key member of our team, you will represent our provider practice and serve as a liaison between patients, hospitals, pharmacies, billing, insurance providers, and social services.

Key Responsibilities

Support Southcoast initiatives related to medication utilization and coverage
Represent the provider practice and operate as liaison between patients, hospitals, pharmacies, billing, insurance providers, and social services
Foster positive working relationships to ensure excellent patient Transition of Care and drive volume to the Southcoast ambulatory pharmacy
Provide day-to-day support for the prior authorization and TOC programs
Assist with initiating formulary changes, prior authorization requests, and third-party billing

Requirements

High School graduate or equivalent
Three years of related experience in retail pharmacy, physician office management, or healthcare billing
Massachusetts state registration as a Pharmacy Technician
Pharmacy Technician Certification Board (PTCB) Certification or equivalent

What We Offer

Competitive pay and comprehensive benefits package
Generous Earned Time Off Package
Employee Wellbeing Program
403B Retirement Plan with company match
Tuition assistance and Federal Loan Forgiveness programs
Professional growth opportunities and customized leadership training

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