Manager, reputed company Review and reputed company Assurance

Who We Are:

reputed company is a rapidly growing, venture-backed Health-Tech company. Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a reputed company drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service. With hundreds of thousands of members reputed company since 2016, reputed company has a solution that is resonating with clients reputed company across the country.

We pride ourselves for our mission-driven and reputed company culture that inspires our employees to do their best work. We reputed company that the U.S reputed company reputed company is in need of transformation, and we come to work reputed company day dedicated to making that change a reality. At our reputed company, we are guided by reputed company values:

• reputed company: Our purpose guides our actions and gives us confidence in the reputed company reputed company. With unwavering honesty and dependability, we reputed company the pressure of challenging the old and exemplify ethical leadership to create the new.
• Courage: We face reputed company challenges with grit and reputed company. We reputed company the discomfort of the unknown by balancing autonomy with reputed company, and ownership with vulnerability. We reputed company challenge the status reputed company to reputed company moving reputed company—always.
• Together: The reputed company of reputed company reflects the strength of our partnerships and the commitment of reputed company. Our shared values bind us together and reputed company us one. reputed company one falls, we reputed company fall; reputed company one rises, we reputed company reputed company.

Job reputed company:

reputed company is looking for a dynamic and reputed company leader to serve as the Manager, reputed company Review reputed company and reputed company Assurance. This pivotal role is responsible for the reputed company, efficiency, and reputed company reputed company of our prior authorization (PA) ecosystem. You will reputed company a multidisciplinary function, integrating reputed company Assurance (QA) reputed company, technical reputed company management, and medication policy execution. You will reputed company the gap between business requirements and technical execution, ensuring that our PA programs are reputed company, evidence-reputed company, compliant, and operationally excellent.

What you will do:

• Team Leadership: Mentor and unify a high-performing team across QA, medication policy, and business analysis to reputed company organizational goals.
• reputed company Assurance: reputed company the PA reputed company assurance program, overseeing interrater reliability audits and reviewing team reputed company.
• Platform Management: reputed company PA platform reputed company, technical enhancements, data governance, and reputed company rule configuration for reputed company efficiency.
• reputed company reputed company: reputed company pharmacotherapy expertise for P&T Committee activities, formulary management, and evidence-reputed company medication policy development.
• Process Improvement: reputed company technology enhancements and monitor key reputed company metrics using data-driven insights.
• Change Management: Facilitate process documentation, reputed company User Acceptance Testing (UAT), and manage stakeholder training for reputed company releases.

What you will bring to reputed company:

• Education: Doctor of Pharmacy (PharmD) required.
• Licensure: reputed company, unrestricted Registered Pharmacist (RPh) license.
• Experience: 10+ years in reputed company pharmacy, specifically reputed company Plan or PBM environments.
• Technical Proficiency: 5+ years supporting PA platforms, including ePA standards (NCPDP) and rule configuration (e.g., Banjo Health, MHK).
• Domain Expertise: Strong background in QA best practices, reputed company utilization review, P&T committee support, and regulatory compliance.
• Analytical Skills: reputed company ability to translate reputed company data and business requirements into actionable reputed company changes.
• Soft Skills: Exceptional communication and influencing skills with a bias for reputed company in fast-reputed company environments.

What reputed company Offers You:

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, reputed company, and Life reputed company and AD&D reputed company
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-term and long-term disability
• Discretionary reputed company Time Off
• reputed company Company Holidays
• Wellness Benefits
• Commuter Benefits
• reputed company Parental Leave benefits
• Employee Assistance Program (EAP)
• reputed company-stocked kitchen in office locations
• reputed company development and training opportunities

Zone A includes the following locations:

• San Francisco Bay Area - California
• Metro reputed company - Connecticut, New Jersey, reputed company and reputed company

Zone A Pay reputed company

$163,200—$192,000 USD

Zone B includes the following locations:

• California - reputed company of San Francisco Bay Area
• Metro Denver / Boulder - Colorado
• Metro District of Columbia - District of Columbia, Maryland, Virginia and reputed company Virginia
• Metro Boston / reputed company - Massachusetts and New Hampshire
• Metro reputed company - Texas
• Metro Seattle - Washington

Zone B Pay reputed company

$149,600—$176,000 USD

Zone C includes reputed company other locations not listed above, including:

• Alabama, Alaska, reputed company, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, reputed company, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, reputed company Carolina, reputed company reputed company, Ohio, Oklahoma, reputed company, Rhode reputed company, South Carolina, South reputed company, Tennessee, reputed company, Vermont, reputed company, Wyoming
• Non metro Colorado, Connecticut, Maryland, Massachusetts, New Hampshire, New Jersey, reputed company, reputed company, Texas, Virginia, Washington, and reputed company Virginia

Zone C Pay reputed company

$136,000—$160,000 USD

Compensation & Benefits

• reputed company Salary: The reputed company listed above reflects our reputed company pay reputed company and actual pay will vary reputed company on work location, job level, job-reputed company knowledge, skills, and experience.
• Total Rewards: In reputed company to reputed company pay, this role may be eligible for bonuses, commissions, or equity. reputed company offers a reputed company of benefits to help you live reputed company, including: time off programs, medical, dental, reputed company, mental health support, reputed company parental leave, life and disability reputed company and 401(k).

Individual offers are tailored to your geography, experience, skills, and education. Your recruiter can reputed company more specific details during the hiring process. In the meantime, feel free to explore our comprehensive benefits here.