Prior Authorization Supervisor

2 weeks, 4 days ago
Full-time
Lead
Customer and Technical Support
Shields Health Solutions

Shields Health Solutions

Shields Health Solutions is the first and largest company in the nation to integrate specialty pharmacies within hospitals, focusing on improving patient outcomes and system-wide growth. Their programs and data platforms reduce costs, achieve better cl...

Health Care Providers & Services
1K-5K
Founded 2012

Description

  • Direct and manage a team of Patient Support Associates to support medication adherence, refill management, prior authorization, and financial assistance workflows.
  • Proactively manage support for assigned hospitals and clinics to help patients receive medications on time.
  • Ensure service level goals and contract requirements are met while maintaining high-quality patient care.
  • Manage ADP, PTO, and time reporting for team members.
  • Complete audits in supported systems to ensure efficient workflow and accurate operations.
  • Monitor and respond to new requests in supported systems.
  • Provide front-line supervision, coaching, and performance management to Patient Support team members.
  • Coordinate with hospital partners and clinical teams through collaboration calls, team meetings, and status reviews.
  • Create meeting agendas, lead meetings, and document follow-up items and collaboration notes.
  • Assist with hiring, interviewing, onboarding, training coordination, and access requests for new team members.
  • Absorb overflow work during short staffing or high workload periods and support special projects as needed.
  • Manage on-site pharmacy relations and workflows, including claim reversals, delivery slips, care coordination, and phone support.

Requirements

  • 3+ years of pharmacy technician experience, with 3–5+ years preferred in specialty pharmacy.
  • Current registration as a pharmacy technician in the state of employment and national CPhT certification.
  • Willingness to obtain or update required state certification within a mutually agreed timeframe if needed.
  • High school diploma or GED required.
  • Bachelor’s degree preferred or actively working toward a degree.
  • Leadership experience strongly preferred, such as team lead experience or leading other team members without direct reporting authority.
  • Training in leadership or management theory is preferred.
  • Strong communication, interpersonal, and leadership skills with the ability to influence without formal authority.
  • Proficiency in Microsoft Office, especially Excel and Word, with moderately advanced Excel skills including basic formulas, data manipulation, and graph creation.
  • Experience with pharmacy dispensing or EMR systems is desirable; Willow, Qs1, and RX30 are a plus.
  • Strong organizational skills, attention to detail, and the ability to manage and prioritize workload effectively.
  • Ability to maintain discretion and confidentiality with sensitive health information.
  • Willingness to travel up to 20% if working remotely outside a Shields core location.
  • Ability to work collaboratively with both remote and on-site team members.

Interested in this position?

Apply directly on the company website

Apply Now

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