Manager, Clinical Pharmacy for Prior Authorization- Remote

Sentara Health; Virginia Beach (VA); Remote; USD 113,000 - 155,000; Full time

Job summary

An established industry player is seeking a Manager for Clinical Pharmacy to oversee prior authorization processes in a fully remote role. This position involves managing clinical pharmacy programs, ensuring compliance with regulatory requirements, and leading a team of pharmacists. The ideal candidate will have extensive experience in pharmacy management and a passion for improving healthcare outcomes. Join a dynamic organization that values its employees and fosters a supportive work environment, offering competitive benefits and opportunities for professional growth.

Benefits

Medical, Dental, Vision plans

Tuition Assistance

401k/403B with Employer Match

Paid Time Off

Emergency Backup Care

Life Insurance

Student Debt Pay Down

Pet Insurance

Legal Resources Plan

Reimbursement for certifications

Qualifications

• 5+ years of experience as a pharmacist in a health plan setting.
• Experience in managed care and pharmacy benefit management is required.

Responsibilities

• Manage clinical pharmacy programs and coordinate prior authorization workflows.
• Lead a team of clinical pharmacists and collaborate with health services.

Skills

Clinical Pharmacy Management

Utilization Management

Regulatory Compliance

Staff Management

Data Analysis

Education

Bachelor's Degree in Pharmacy

Job description

Manager, Clinical Pharmacy for Prior Authorization- Remote

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Manager, Clinical Pharmacy for Prior Authorization- Remote

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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

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!

• 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)
  
  
  

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

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 if established 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.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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