Prior Authorization Manager

Description

About Us:
 

What We’re About…TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and customized level to ensure optimum value at the lowest possible cost. We are committed to lowering prescription drug spending, achieving clinically effective outcomes, and always delivering Amazing Care. Did we mention Amazing Care? Good! Because this is so much more than just our tagline. It is the foundation upon which our business was built. We believe that Amazing Care starts from within, and our culture is reflective of this philosophy. 

Our team members enjoy:

• A wide range of health insurance options including medical, dental and vision
• A strong salary and bonus program
• A robust 401k and company match
• Truescripts is transitioning to an ESOP, a team member owned company! Each year team members are allocated shares of stock through our ESOP, a Qualified Retirement plan!
• Employee Assistance Program
• A wellness program including financial incentives, chiropractic and massage services, and fitness stipends
• Dream Manager Program (yes, it’s a real thing!)
• A cohesive, family-based culture
• Charitable contributions and volunteer time
• Lots of celebrations!

Ok, enough about us. Here’s what we need from you: A future team members' values need to align with TrueScripts' core values of Integrity, Respect, Innovation, and Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a ‘can do, proactive attitude. Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed. 

About the Role:
 

The Prior Authorization Manager is responsible for ensuring our members receive exceptional service. This position will assist the Clinical Program Operations team in the leadership, supervision, coordination, mentoring, career development, and performance management of all Prior Authorization team members. This position will work with leadership to execute tasks related to team training, daily departmental operations, and provide efficient and effective management, administration, and overall staff direction that will be in support of the company strategic goals. The Prior Authorization Manager will be an expert in the use of PA navigation software. This role will act as liaison and clinical consultant with clinical review vendor and TrueScripts Clinical and Member Care teams.

What You’ll Do:

Primary Roles and Responsibilities:

• Become an expert in the Prior Authorization role and responsibilities including comprehension of company programs and services offered.

• Lead the Prior Authorization team with a customer service first mentality.

• Consult with clinical review vendor and provide clinical recommendations based on formulary and plan guidelines.

• Assist with evaluation of individual performance and recommendations to leadership for departmental wage increases and bonus payouts. 

• Ensure collaboration across the organization.

• Ensure that each representative is competent in their primary responsibilities through ongoing training and education, periodic performance evaluations, and competency testing.

• Interact regularly with the leadership to ensure that the team’s operational priorities align with the company’s direction.

• Problem solves issues and communicates team needs.

• Analyze data to identify trends and opportunities for improvement in the prior authorization process. 

Requirements

What You’ll Bring:

Qualifications:

• Bachelor’s degree in pharmacy or PharmD preferred.

• Direct supervision and leadership experience are preferred.

• Experience in prior authorizations and/or retail pharmacy experience preferred.

• Effective communication and presentation skills.

• Attention to detail.

• Ability to prioritize.

• Organized.

• Ability to work under stress.

• Self-motivated.

• Collaborative.

• Provide direct, honest, constructive criticism and coaching.

• Effective and empathic listening skills.

• Never complacent, but always an innovative mindset

• Genuine desire to serve.

• Proficient in Microsoft Office 365 (Word, Excel, Outlook, etc.).

• Performs other duties as assigned by Sr. Director.