Prior Authorization Supervisor

Curant Health•Smyrna, GA

1d•Hybrid

About The Position

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.

Requirements

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
Strong clinical judgment, leadership ability, and communication skills

Nice To Haves

Knowledge of formulary management, claims processing, managed care, and specialty pharmacy preferred
340B experience is a plus

Responsibilities

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
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
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