Manager, Clinical Pharmacy for Prior Authorization- Remote

Sentara; Virginia, Virginia Beach (MN, VA); Remote; USD 80,000 - 110,000; Full time

Job summary

An established healthcare organization is seeking a dedicated Manager of Clinical Pharmacy for Prior Authorization. This fully remote role requires expertise in managing clinical pharmacy programs, regulatory compliance, and staff management. You will lead a team of Clinical Pharmacists to enhance operational workflows and ensure effective utilization management. Join a forward-thinking company that values community involvement and personal development, and be part of a mission-driven team focused on improving health outcomes for members across various states.

Benefits

Medical, Dental, Vision plans

Adoption, Fertility and Surrogacy Reimbursement

Paid Time Off and Sick Leave

Paid Parental & Family Caregiver Leave

Emergency Backup Care

Long-Term and Short-Term Disability

Life Insurance

401k/403B with Employer Match

Tuition Assistance

Pet Insurance

Qualifications

• 5+ years of experience as a Pharmacist in a health plan.
• Experience in managed care and pharmacy benefit management.

Responsibilities

• Manage clinical pharmacy programs and workflows.
• Collaborate with health services and pharmacy management.

Skills

Pharmacy Management

Clinical Pharmacy Programs

Utilization Management

Regulatory Compliance

Staff Management

Education

Bachelor's Degree in Pharmacy

Job description

City/State

Virginia Beach, VA

Work Shift

First (Days)

Overview:

Sentara Health Plans is hiring for a Manager, Clinical Pharmacy for Prior Authorization- Remote!

Status: Full-time, permanent position (40 hours)

Work hours: 8am to 5pm EST, M-F

Location: This position is fully remote for candidates that live in the following states: VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY!

Job Description Summary

• This position will manage and coordinate clinical pharmacy programs, including formulary and utilization management, reporting, outcomes assessment, and regulatory requirements.

• This position will report to the VP, Pharmacy- Sentara Health Plans and will require close collaboration with other management in the pharmacy department, as well as coordination with the health services team.

• This position will also be required to analyze systems, programs, and resources to maximize their effectiveness.

• This position will lead our clinical prior authorization operations workflows including electronic prior authorization build and staff management of 15 direct reports (Clinical Pharmacists)

Education

• BLD - Bachelor's Level Degree in Pharmacy REQUIRED

Certification/Licensure

• Licensed in VA REQUIRED

Experience

• Pharmacist- 5 years experience REQUIRED

• Health Plan- 4 years experience REQUIRED

• Managed Care- 4 years experience REQUIRED

• Management- 1 year experience REQUIRED

• Pharmacy Benefit Manager- 4 years experience REQUIRED

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-72641

#LI-PM1

Talroo - Health Plan

Pharmacy, Managed Care, PharmD, Licensed Pharmacist, Virginia, MCO, Health Plan, Healthcare, Remote, Prior Authorization, Pre Auth,

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, Wyoming

Benefits: Caring For Your Family and Your Career

* Medical, Dental, Vision plans

* Adoption, Fertility and Surrogacy Reimbursement up to $10,000

* Paid Time Off and Sick Leave

* Paid Parental & Family Caregiver Leave

* Emergency Backup Care

* Long-Term, Short-Term Disability, and Critical Illness plans

* Life Insurance

* 401k/403B with Employer Match

* Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education

* Student Debt Pay Down - $10,000

* Reimbursement for certifications and free access to complete CEUs and professional development

*Pet Insurance
*Legal Resources Plan
*Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission "to improve health every day," this is a tobacco-free environment.

For positions that are available as remote work,Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.