Sentara Healthcare
Pharmacy Prior Authorization Coordinator I
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Job Description
- Req#: JR-93674
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Must reside in Virginia or North Carolina for this remote position
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including medical, dental, and vision plans
- Generous tuition assistance program of $5,250/year and student debt pay down of $10,000
- Potential to earn an annual discretionary bonus based on eligibility criteria
- Supportive and diverse work environment with a focus on inclusion
What to Expect (Job Responsibilities):
- Manage and respond to calls from members, provider offices, and pharmacies regarding prior authorization requests
- Process prior authorization requests for pharmacy benefit medications ensuring compliance with regulatory and clinical guidelines
- Utilize established protocols and systems to support timely and accurate prior authorization determinations
- Collaborate with healthcare providers to gather necessary information for authorization requests
- Maintain accurate records of all interactions and transactions related to prior authorizations
What is Required (Qualifications):
- Must be a licensed Pharmacy Technician or a Certified Medical Assistant
- Virginia Pharmacy Tech License and CPhT License (through NHA or PTCB) required
- High School Diploma or equivalent
- Minimum of 1 year of experience in Managed Care, Health Plan, or PBM preferred
- Minimum of 1 year of experience in Pharmacy Call Center or Authorization preferred
How to Stand Out (Preferred Qualifications):
- Experience with prior authorization processes in a pharmacy setting
- Familiarity with pharmacy benefit management systems
- Strong customer service skills and ability to handle high-volume calls
- Knowledge of regulatory and clinical guidelines related to pharmacy benefits
- Certification in additional medical or pharmacy-related fields
#HealthcareServices #PharmacyTechnician #RemoteWork #CareerGrowth #DiversityAndInclusion
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Sentara Healthcare is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina.
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