Clinical Pharmacist Supervisor – Prior Authorization

This is a fully remote position, open to applicants in United States.

📋 Description

• Supervise a team of pharmacists conducting clinical reviews for prior authorizations and appeals.

• Oversee daily operations, including workflow management, queue monitoring, and scheduling.

• Ensure that the pharmacist team adheres to clinical accuracy standards and meets response deadlines.

• Track productivity and quality metrics regularly.

• Provide individualized coaching, conduct performance evaluations, and facilitate cross-training.

• Analyze, troubleshoot, and resolve intricate, high-priority prior authorization cases and appeals.

• Work in conjunction with the Clinical Quality team on routine assessments.

• Offer coaching, training, and performance support based on audit results.

• Recognize and implement improvements to existing processes.

• Collaborate with cross-functional leaders to create and organize job aids and training materials.

• Participate in a rotating schedule for weekend and holiday on-call duties.

• Ensure compliance with relevant laws and regulations.

• Report directly to the Manager of Pharmacy Utilization Management.

⛳️ Requirements

• Doctor of Pharmacy degree.

• Active and unrestricted pharmacist license.

• A minimum of 4 years of experience in managed care involving clinical review/utilization management.

• At least 1 year of experience in people or project management.

• Experience leading a team of clinical pharmacists in clinical review/utilization management operations (preferred).

• Proven experience in developing and overseeing key performance indicators/metrics for an operational team (preferred).

• Strong clinical skills and experience in applying clinical criteria within a clinical review environment (preferred).

🏝️ Benefits

• Comprehensive employee benefits.

• Unlimited vacation program.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick leave.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life insurance coverage.

• Disability insurance.

• Paid wellness time and reimbursements.

• Occasional travel for team meetings and company events.