Director, Prior Authorization & Clinical Operations

Truescripts-Management-Services; Washington (IN); Sur place; USD 140 000 - 190 000; Plein temps

Avantages offerts par ce poste

Health insurance

Bonus program

401k with company match

ESOP

Employee Assistance Program

Wellness program

Dream Manager Program

Volunteer time / Charitable donations

Résumé du poste

TrueScripts Management Services is seeking a Director, Prior Authorization to lead the strategic direction, performance, and operational excellence of the Prior Authorization function. The role oversees clinical reviews, vendor partnerships, quality, and regulatory compliance while working with Clinical Programs, Member Care, Client Services, Operations, Technology, and Leadership.

Requirements include 7–10 years in pharmacy or utilization management with 3–5 years in leadership, plus strong

Qualifications

• BSPharm or PharmD and active pharmacist license in good standing.
• 7-10 years of pharmacy, clinical operations, prior authorization, utilization management, or related healthcare experience.
• 3-5 years of leadership experience with responsibility for team performance and operational outcomes.
• Strong analytical and problem-solving skills; experience using data to drive decisions.

Responsabilités

• Provide strategic leadership and direction for the Prior Authorization department.
• Establish goals, metrics, and priorities aligned with organizational objectives.
• Lead workforce planning and develop leaders within the department.
• Direct daily Prior Authorization operations to ensure quality and timely service delivery.
• Monitor KPIs, SLAs, and dashboards; identify trends and opportunities.
• Manage vendor relationships and evaluate performance for cost savings and quality.
• Ensure compliance with regulatory and client requirements; promote continuous improvement.

Connaissances

Leadership

Analytics

Communication

Program management

Formation

BSPharm or PharmD

Description du poste

TrueScripts Management Services is seeking a Director, Prior Authorization to lead the strategic direction, performance, and operational excellence of the Prior Authorization function. The role oversees clinical reviews, vendor partnerships, quality, and regulatory compliance while working with Clinical Programs, Member Care, Client Services, Operations, Technology, and Leadership.

Requirements include 7–10 years in pharmacy or utilization management with 3–5 years in leadership, plus strong