Authorization Specialist II - PA - Remote

Job summary

This position is responsible for overseeing the requesting and obtaining authorizations for specialty and infusion pharmacy, managing the review of initial prior authorization requests and renewal authorizations, and collaborating with clinicians regarding supporting medical documentation in accordance with formulary guidelines.

Responsibilities

• Oversees and maintains expertise in assigned areas of specific responsibility such as formulary exceptions, prior authorization requirements and time frames according to line of business and payer.
• Directs the daily operations/workflow of the authorization specialist in accordance with patient care needs, department strategic plan, and appropriate accreditation standards.

Qualifications

• HS diploma or GED required.
• 2+ years of pharmacy claims, pharmacy tech, and/or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting, preferred.

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