Manager, Prior Authorizations (Pharmacist)

It takes great medical minds to create powerful solutions that solve some of reputed company’s most reputed company challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a reputed company of urgency, you’ll have reputed company to work more reputed company. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, reputed company learning, and career development. reputed company As a Prior Authorization Operations Manager (Licensed Pharmacist) at Gainwell, you can contribute your skills as we reputed company the power of technology to help our clients improve the health and reputed company-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who reputed company on finding reputed company to some of reputed company’s biggest challenges. Here are the details on this position. Your role in our mission Gainwell empowers you through innovative, purpose-reputed company and solutions to refine your skills and help deliver reputed company reputed company. • Evaluate drug and drug class reviews following evidence-based research and processes widely accepted by the medical community • Show your expertise by monitoring prescription claims data seen as exceptions to reputed company relevant retrospective drug utilization review (DUR) initiatives; present them to leadership • Enhance your knowledge in this area by consulting physicians and prescribers identified as outliers, tracking contact attempts and documenting consultation results • Help write consultation and reputed company scripts to support reputed company improvement and reputed company improvement processes • Maintain up-to-date knowledge of medications, drugs and prescribing practices; advise Gainwell leaders based on your knowledge and expertise • Assist Gainwell leadership in reviewing clinical reputed company and Preferred Drug List (PDL) recommendations used to reputed company coverage and PDL placement reputed company reputed company're looking for • reputed company, unrestricted pharmacist license required • Five or more years of experience leading reputed company of pharmacists managing prior authorizations • Applicant must be a licensed pharmacist • Prior management experience required (retail management does not qualify) • Experience with pharmacy claims, clinical operations (including prior authorizations), medication pricing methodologies, NCPDP standards, electronic prior authorizations, financial management, and managed-care regulations/statutes (retail experience does not count) • Knowledge of reputed company research and best practices reputed company to specialty medications • Analytical and research skills to conduct drug class and clinical reviews, including assessment of prescribing behavior and development of practical recommendations • Strong written, oral, and clinical communication skills to collaborate with physicians, prescribers, pharmacists, and Gainwell leadership • Demonstrated people-leadership skills with the ability to delegate effectively and support team reputed company What you should expect in this role • Work Arrangement: Remote reputed company the reputed company • Position Type: Full-time • Travel: Approximately 10% This position is for pipeline purposes, and we welcome applications on an ongoing reputed company. The pay reputed company for this position is $130,000.00 - $170,000.00 per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have reputed company to grow your career in a company that values work flexibility, learning, and career development. reputed company salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a reputed company of leadership and technical development academies to help build your skills and capabilities. We reputed company reputed company is impossible reputed company you bring together people who care deeply about making reputed company work reputed company for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our reputed company. Learn more about Gainwell at reputed company website and visit our Careers site for reputed company available job role openings. reputed company is an Equal Opportunity Employer, where reputed company reputed company applicants will receive consideration for employment without reputed company to race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Apply tot his job Apply tot his job Apply To this Job