PHARMACY PRIOR-AUTHORIZATION COORDINATOR I

Company: Sentara
Location: Norfolk
Posted on: November 22, 2022

Job Description:

City/StateNorfolk, VAOverviewWork ShiftSwing Shift (United States of America)Job SummaryUnder the direct supervision of a Pharmacy Team Coordinator, the pharmacy prior authorization coordinator (PAC) is responsible for supporting the Pharmacy Department's day-to-day operations for the call center and prior authorization cases for all lines of business (Medicaid, Medicare, Exchange and Commercial). At a minimum, the PAC provides knowledgeable and courteous customer service and response to members and providers. This position handles member/provider requests/inquiries regarding pharmacy benefits, prior authorizations, or claim resolution. The PAC also uses the pharmacy computer system to facilitate prior authorizations and participate in patient/provider/customer care activities that do not require the expertise of a pharmacist.

This position will be an internal resource interfacing with members, providers, and internal departments' personnel to resolve pharmacy claims and prior authorization issues.

The Pharmacy Prior Authorization Coordinator will be able to accept ownership for effectively solving member or provider issues, complaints, and inquiries, keeping member satisfaction at the core of every decision and behavior.

1 year of Managed Care, Health Plan or PBM experience preferred.

1 year of Pharmacy Call Center or Authorization experience preferred.

State registration required based on location, VA or NCQualifications:HS - High School Grad or EquivalentCertified Pharmacy Technician (CPhT) - Other/National, NHA Pharmacy Technician Certification (CPhT) - Other/National, Pharmacy Technician Registration - Arkansas, Pharmacy Technician Registration - North CarolinaCall Center, Managed Care, Pharmacy TechnicianSkillsActive Learning, Active Listening, Communication, Learning Strategies, Microsoft Office, Monitoring, Quality Control Analysis, Reading Comprehension, Service Orientation, Time ManagementSentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission "to improve health every day," this is a tobacco-free environment.

Keywords: Sentara, Norfolk , PHARMACY PRIOR-AUTHORIZATION COORDINATOR I, Other , Norfolk, Virginia