ENGLEWOOD, CO, 80113, USA
11 days ago
Prior Authorization Supervisor
Our Company Amerita Overview Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals. The Prior Authorization Supervisor will monitor and provide staffing direction in their specific workflow vertical. They are responsible for oversight of activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations, and will oversee the enhanced PA program. This role requires advanced program and working knowledge of pharmacy benefits and prior authorization process and will provide quality control by routinely examining cases completed by team members, review of prior authorization approval and denial rates and trends, and process reviews. • Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts• Supplemental Coverage – Accident, Critical Illness and Hospital Indemnity Insurance• 401(k) Retirement Plan with Employer Match• Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability• Employee Discounts• Tuition Reimbursement• Paid Time Off & Holidays Responsibilities + Supervises PA staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee relations issues and reduce turnover + Communicates effectively across pharmacy and/or corporate teams and with patients, and successfully resolves issues + Assists Manager in day-to-day pharmacy operations and in implementing new procedures to ensure that the accurate and timely dispensing of quality pharmacy services is consistently delivered to all patients using effective service leadership and customer skills + Manages and reports on activity of vertical team members, including managing of daily workflow and productivity trends + Monitors and validates adherence to Policies and Procedures within the Document Management team, auditing as necessary to ensure productivity and performance to goals are accomplished or exceeded + Manages daily auditing reports and workflow to ensure the prior authorization is initiated on the correct form based on review of the benefit verification, claim responses, clinical notes provided and prescriber preferences + Knowledgeable to perform all PA functions and resolves escalations regarding difficult cases + Provides thorough, accurate and timely responses to requests + Implements and follows up on progress of any operational changes and updates to the PA process with the PA team and key stakeholders + Maintains a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws + Contributes to team effort by accomplishing related tasks as needed and other duties as assigned + Conducts job responsibilities in accordance with standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards Qualifications + High School Diploma/GED, previous experience in pharmacy and prior authorizations, associates or bachelor’s degree or equivalent experience + Required 4+ years pharmacy experience, 1+ years supervisor experience required + Excellent interpersonal skills, able to work with all levels of management and staff, vast knowledge of pharmacy insurance and benefit verification + Ability to multitask in a demanding environment + Excellent organizational skills and mindfulness About our Line of Business Amerita is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness and entrepreneurial spirit of a local provider. For more information about Amerita, please visitwww.ameritaiv.com. Follow us onTwitter (https://twitter.com/AmeritaIV) and LinkedIn (https://www.linkedin.com/company/amerita-inc/) . Salary Range USD $59,280.00 - $80,080.00 / Year ALERT: We are aware of a scam whereby imposters are posing as employees from our company. Beware of anyone requesting financial or personal information. We take pride in creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, driver’s license, bank information, or payment for work equipment, etc.) from you via text or email. If you are suspicious of a job posting or job-related email mentioning our company, please contact us at TalentAcquisition@brightspringhealth.com . Click here (https://www.brightspringhealth.com/careers/frequently-asked-questions/) for additional FAQ information. Job LocationsUS-CO-ENGLEWOOD ID 2024-156851 Line of Business Amerita Position Type Full-Time Pay Min USD $59,280.00/Yr. Pay Max USD $80,080.00/Yr.
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