CarepathRx

Compensation

Full Description

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services. Job Details: This position is responsible to oversee the requesting and obtaining authorizations for specialty and infusion pharmacy. Manage the review of initial prior authorization requests and renewal authorizations. Collaborate with clinicians regarding supporting medical documentation in accordance with formulary guidelines. Manage the quality review of requested prior authorizations. Additional responsibilities include orientation and mentoring new staff and daily oversight of team members. Also, monitoring the performance of the authorization team and create and update policies and procedures. Responsibilities Oversees and maintains expertise in assigned areas of specific responsibility such as formulary exceptions, prior authorization requirements and time frames according to line of business and payer. Ensures initial and renewal authorizations are followed up on appropriately. Directs the daily operations/workflow of the authorization specialist in accordance with patient care needs, department strategic plan, and appropriate accreditation standards. Create work schedules, implement guidelines, conduct staff meetings and update personnel on company updates i.e., internal processes and contracts. Manage recruitment, hiring, training, evaluation, and competency of personnel; maintains a quality workforce. Monitors performance and compliance of reporting personnel and provides feedback via performance evaluations and disciplinary action when necessary. Initiates disciplinary action and makes recommendations for corrective action and improvement of performance Ensure achievement of productivity standards and adherence to regulations and standards of performance and accreditation. Collaborate with the team to identify efficiencies. Acts as a resource to all personnel to resolve problems and answer questions regarding intake operations. Takes the initiative to present ideas/suggestions to management. Performs in accordance with system-wide competencies/behaviors. Performs other duties as assigned. Skills & Abilities Excellent written and verbal communication Organized High Integrity Interpersonal skills Adaptability Time Management Conflict resolution Qualifications HS diploma or GED required 2+ years of pharmacy claims, pharmacy tech, and/or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting, preferred Knowledge of medical terminology, coordination of benefits Knowledge of payer websites preferred Knowledge of medical terminology preferred Knowledge of pharmacy payers and authorization requirements preferred Proficient computer skills and Microsoft Office Products, preferred Excellent customer service skills Self-starter with the ability to work with minimum supervision CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire. CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country. CarepathRx is transforming pharmacy care delivery for health systems and hospitals, delivering improved patient outcomes that drive clinical, quality and financial results. Through the industry’s most comprehensive, end-to-end hospital pharmacy care delivery model, CarepathRx is turning hospital pharmacy into an active care management strategy and revenue generator while providing support across the patient’s complete healthcare journey. The company takes an enterprise approach, providing a powerful combination of technology, market-leading clinical pharmacy services, and wrap-around services that optimize pharmacy performance across the enterprise for fully integrated pharmacy operations, expanded healthcare services, improved ambulatory access, minimized clinical variation and new health system revenue streams. Today, CarepathRx serves more than 15 health systems and 600 hospitals, with more than 2,400 employees nationwide. For more information about CarepathRx, visit our website. We are always searching for the best talent to join our growing organization. Check out our available opportunities by using the search functionality and filtering options at the top! CarepathRx offers full-time employees a comprehensive benefits package that includes: Paid Company Holidays Paid Time Off and Volunteer Time Off Medical, Dental and Vision Benefits for you and your family 401(k) with Company Match Company-paid Life Insurance and Disability Benefits Supplemental Insurance packages Don't see an open opportunity that matches your skill set just yet? Please click Get Started below or click Introduce Yourself in the top right corner of the page to share your information with us. We will reach out when something becomes available! Additionally, create an account with CarepathRx Careers to set up Job Alerts if something becomes available that peaks your interest! To create an account with CarepathRx Careers, click on Sign In in the top right corner. Once you have created an account and are logged in, click on Job Alerts in top right corner and Create Job Alert! We hope you find a fulfilling career with CarepathRx!