[Hiring] Specialist III, Prior Authorization @Navitus Health Solutions

Role Description

Due to growth, we are adding a Specialist III, Prior Authorization to our team. Under direction from the Supervisor, Prior Authorization, and other leaders at Lumicera, the Specialist III, Prior Authorization is primarily responsible for coordinating and directing the day-to-day operations of the Prior Authorization team. This position will support and foster team success of the Prior Authorization Specialists through leading by example with subject matter expertise and coaching teammates. Achieving success in this position will be represented by reaching team goals for key performance indicators, provider and patient satisfaction, and continual workflow improvement.

The Specialist III, Prior Authorization will also be responsible for:

• Assisting the team with obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy.
• Solving problems in both overcoming challenges operationally while serving as a point of contact for other associates with escalations with the goal of achieving the best outcomes for all parties.
• Educating and assisting other areas of Lumicera as needed related to prior authorization type duties.

Responsibilities

• Cultivate a dynamic team environment for the Prior Authorization team that is engaging, supportive, positive, and forward thinking.
• Communicate effectively with the prior authorization team to assign daily tasks, provide guidance in complex problem-solving scenarios, and drive accountability on overall team key performance indicator goals.
• Serve as a trainer for new and existing Prior Authorization Specialists on core job responsibilities to fulfill the needs of the patient and providers related to prior authorizations.
• This may include, but not limited to, RxVector, NCRX, Lighthouse, Banjo, Cover My Meds, phone platforms and proper documentation and communication.
• Identify and present opportunities for workflow and process improvement to direct supervisor and/or Lumicera leadership.
• Provide daily support for new and established associates, i.e. making sure they understand new protocols, workflows, assist in the promulgation of information, answering day-to-day operations questions.
• Responsible for assisting in prior authorization workflow when needed with phones and work queues related to patients, prescribers, and other healthcare professionals.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

Qualifications

• High School diploma or GED.
• National CPhT and/or registration/licensure per associate’s residing state’s requirements.
• 2+ years pharmacy support experience or healthcare environment experience.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance.
• 20 days paid time off.
• 4 weeks paid parental leave.
• 9 paid holidays.
• 401K company match of up to 5% - No vesting requirement.
• Adoption Assistance Program.
• Flexible Spending Account.
• Educational Assistance Plan and Professional Membership assistance.
• Referral Bonus Program – up to $750!