Lead, Clinical Review Pharmacist

Responsibilities

• Directly manage, coach, and mentor a team of prior authorization Pharmacists
• Drive and maintain regulatory, compliance, and accreditation standards for the clinical review team
• Recruit, hire, and lead training and onboarding for new team members
• Manage team performance through the measurement of key performance indicators (KPIs)
• Provide day-to-day supervision, support, and escalation paths for Pharmacists
• Identify and drive operational process improvements to support business scaling
• Collaborate cross-functionally with departments regarding eligibility, claims, and benefit designs
• Participate in the Pharmacy and Therapeutics Committee process to develop clinical criteria for medications

• 5+ years of health plan or PBM experience, specifically in prior authorization review
• 3-5+ years of management experience
• Bachelor's degree in Pharmacy or Doctor of Pharmacy (Pharm
  
  D)
• Active Pharmacist License
• Knowledge of regulatory and accreditation standards including ERISA, ACA, Medicare, URAC, and NCQA
• Proficiency in Mac, MS Office, and G-Suite
• Strong communication skills with the ability to present complex information to various stakeholders

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance
• 401(k) Retirement Savings Program
• Discretionary Paid Time Off and Paid Company Holidays
• Paid Parental Leave
• Flexible Spending Benefits and Commuter Benefits
• Professional development and training opportunities