Clinical Pharmacy Prior Authorization Specialist

UCI group; Irvine (CA); Hybrid; USD 85,000 - 120,000; Full time

Benefits offered by this job

Medical insurance

Sick and vacation time

Retirement savings plans

Discounts and perks

Job summary

UCI Health in Irvine, California seeks a PAL Clinical Specialist to support prior authorization and utilization management, focusing on appeals and clinical judgment in submissions to payers. The role processes urgent and routine authorizations while ensuring compliance with clinical protocols and payer guidelines.

The position collaborates with internal departments, providers, and health plans, driving timely determinations and high-quality patient care within a busy authorization workflow.

Qualifications

• Knowledge of drug references, Joint Commission requirements, and regulatory standards.
• Customer service skills appropriate to the job.
• English communication—written and verbal.

Skills

Regulatory knowledge

Customer service skills

English communication

Education

Doctor of Pharmacy degree

Job description

UCI Health in Irvine, California seeks a PAL Clinical Specialist to support prior authorization and utilization management, focusing on appeals and clinical judgment in submissions to payers. The role processes urgent and routine authorizations while ensuring compliance with clinical protocols and payer guidelines.

The position collaborates with internal departments, providers, and health plans, driving timely determinations and high-quality patient care within a busy authorization workflow.