Prior Authorization Supervisor

3 days ago

Smyrna, Georgia, United States Curant Health Full time

Join a Leading Healthcare Company
At Curant Health, our vision is to personalize healthcare—driven by choice and defined by value. Our employees bring this vision to life through excellent service, personalized care, accountability, innovation, and integrity. We offer competitive pay, great benefits, and the opportunity to make a meaningful impact every day. We are seeking a
Prior Authorization Supervisor
in Smyrna, GA or St. Petersburg, FL to oversee clinical and operational Prior Authorization (PA) processes and ensure timely access to specialty medications.

Position Summary

The Prior Authorization Supervisor provides clinical and operational oversight for PA activities across Commercial, Medicaid, Medicare, and Co-op lines of business. This role directly supervises PA Specialists and Technicians in both locations, supports clinical calls, manages workflow, handles appeals, and ensures full compliance with regulatory and client requirements.

Responsibilities
Operational & Clinical Oversight

  • Oversee daily PA requests following established clinical criteria and benefit rules
  • Review initial PA requests, complete first-level appeals, and coordinate second-level appeals
  • Support Customer Care with medication-related clinical calls
  • Monitor accuracy, efficiency, and quality of coverage determinations
  • Serve as a clinical resource for internal teams, prescribers, and clients
  • Stay current on clinical guidelines and communicate updates

Reporting, Compliance & Program Support

  • Prepare and coordinate PA and drug-utilization reporting
  • Ensure compliance with regulatory, fraud, waste, and abuse requirements
  • Maintain understanding of URAC standards
  • Support rare disease program initiatives and manufacturer patient programs

Leadership & Department Management

  • Supervise PA Specialists and Technicians, including hiring, training, and performance reviews
  • Plan and direct daily PA operations across both locations
  • Manage department staffing, workload, and coverage
  • Identify and escalate operational issues appropriately
  • Develop and update PA protocols with Pharmacy Leadership
  • Foster strong communication across operational teams
  • Create and maintain training materials and support ongoing staff development

Qualifications

  • Advanced degree in Pharmacy with at least 3 years of experience
  • Active pharmacist license in applicable state
  • PA experience in pharmacy, PBM, or managed care required
  • Knowledge of formulary management, claims processing, managed care, and specialty pharmacy preferred
  • 340B experience is a plus
  • Strong clinical judgment, leadership ability, and communication skills

Why Work for Us?

We offer competitive pay, paid holidays, PTO, parental leave, employee prescription discounts, training and development, recognition programs, and internal promotion opportunities. Our ICARE values—Integrity, Communication, Accountability, Relationships, and Excellence—guide everything we do. Curant Health is an equal opportunity employer.

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