Specialist III, Prior Authorization

Navitus Health Solutions, LLC•,

30d•$21 - $25•Remote

About The Position

Due to growth, we are adding a Specialist III, Prior Authorization to our team. Under direction from the Supervisor, Prior Authorization, and other leaders at Lumicera, the Specialist III, Prior Authorization is primarily responsible for coordinating and directing the day-to-day operations of the Prior Authorization team. This position will support and foster team success of the Prior Authorization Specialists through leading by example with subject matter expertise and coaching teammates. Achieving success in this position will be represented by reaching team goals for key performance indicators, provider and patient satisfaction, and continual workflow improvement. The Specialist III, Prior Authorization will also be responsible for assisting the team with obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Specialist III, Prior Authorization will solve problems in both overcoming challenges operationally while serving as a point of contact for other associates with escalations with the goal of achieving the best outcomes for all parties. This position will function with, educating and assisting other areas of Lumicera as needed related to prior authorization type duties.

Requirements

High School diploma or GED required
National CPhT and/or registration/licensure required per associate’s residing state’s requirements
2+ years pharmacy support experience or healthcare environment experience required
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees

Responsibilities

Cultivate a dynamic team environment for the Prior Authorization team that is engaging, supportive, positive and forward thinking
Communicate effectively with the prior authorization team to assign daily tasks, provide guidance in complex problem-solving scenarios, and drive accountability on overall team key performance indicator goals
Serve as a trainer for new and existing Prior Authorization Specialists on core job responsibilities to fulfill the needs of the patient and providers related to prior authorizations. This may include, but not limited to, RxVector, NCRX, Lighthouse, Banjo, Cover My Meds, phone platforms and proper documentation and communication
Identify and present opportunities for workflow and process improvement to direct supervisor and/or Lumicera leadership
Provide daily support for new and established associates, i.e. making sure they understand new protocols, workflows, assist in the promulgation of information, answering day-to-day operations questions
Responsible for assisting in prior authorization workflow when needed with phones and work queues related to patients, prescribers, and other healthcare professionals
Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives
Other duties as assigned