Prior Authorization Pharmacist

Curant Health•Smyrna, GA

12d

About The Position

Curant Health is searching for a Prior Authorization Pharmacist to join its team in Smyrna, GA. The Prior Authorization Pharmacist oversees clinical and operational aspects of specialty medication prior authorizations. This role involves processing and evaluating PA requests, supervising PA specialists, and serving as a clinical resource to both internal and external stakeholders.

Requirements

Doctor of Pharmacy (PharmD) with at least 2 years of experience and licensed in the state of practice.
Prior experience with prior authorizations, clinical pharmacy, and managed care is preferred.

Nice To Haves

Knowledge of PBM, formulary management, and 340B is a plus.

Responsibilities

Review and process prior authorization requests based on clinical criteria and member benefits.
Coordinate drug utilization review reports and ensure compliance with regulatory requirements.
Handle clinical calls from Customer Care for medication-related prior authorizations.
Manage PA appeals and ensure adherence to policies and procedures.
Act as a clinical resource for internal teams, prescribers, and clients.
Monitor and improve the quality and efficiency of the Coverage Determination process.
Stay updated on clinical guidelines and provide relevant insights for program development.
Supervise the Prior Authorization Department, ensuring operational efficiency and training.
Develop and implement departmental protocols and training materials.