Clinical Pharmacy Ops & Prior-Auth Specialist

Marshall Health; United States; On-site; USD 42,000 - 58,000; Full time

Job summary

Marshall Health is seeking a Clinical Pharmacy Technician to manage prior authorizations, gather documentation, submit payer forms, and monitor determinations, with clinical questions escalated as needed.

The role also includes patient-assistance screening, coordinating pharmacy workflow between Rivers clinics and Marshall Health Network pharmacies, focusing on high-cost therapies, and tracking outcomes to support leadership with reports.

Qualifications

• Minimum 2 years' experience in clinical patient care management preferred.
• Specialty medication experience is a plus.
• Retail pharmacy experience preferred.

Responsibilities

• Manage prior authorizations and renewals.
• Gather clinical documentation and submit payer forms.
• Monitor determinations and request additional information as needed.
• Coordinate patient-assistance applications and financial documentation.
• Serve as primary liaison between clinics and network pharmacies.
• Track key metrics and provide routine reports to leadership.

Skills

Clinical Pharmacy Procedures

Patient Care Coordination

Documentation & Communication

Education

National Certification or equivalent

Job description

Marshall Health is seeking a Clinical Pharmacy Technician to manage prior authorizations, gather documentation, submit payer forms, and monitor determinations, with clinical questions escalated as needed.

The role also includes patient-assistance screening, coordinating pharmacy workflow between Rivers clinics and Marshall Health Network pharmacies, focusing on high-cost therapies, and tracking outcomes to support leadership with reports.