PA Navigator: Fast, Compliant Medication Approvals

Western Growers; Fresno (CA); Presencial; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

Western Growers is seeking a Prior Authorization (PA) Specialist to support the clinical pharmacy program by initiating, processing, and tracking PA requests to ensure timely access to therapy.

The role involves gathering and verifying required clinical documentation, communicating with prescribers, payers, and internal stakeholders, and maintaining accurate records in pharmacy systems and payer portals in a HIPAA-compliant manner.

Formación

• Five (5) years of retail pharmacy experience and/or PBM experience; prior authorization experience preferred.
• Current California Board of Pharmacy, Pharmacy Technician license (preferred).
• Proficiency with pharmacy systems and documentation; experience using insurer portals and phone/fax communication; strong Microsoft Office skills (Excel and Word).

Responsabilidades

• Initiate, process, and track PA requests in line with payer requirements and internal workflows.
• Gather, verify, and submit clinical/administrative documentation via payer portals, fax, or phone.
• Enter and update PA status in pharmacy systems; monitor turnaround times and follow up as needed.
• Review denial communications for missing information and initiate retrieval of supporting documentation.
• Coordinate outreach to prescribers, payers, and internal staff to support PA decisions and appeals.

Conocimientos

Pharmacy systems proficiency

Insurer portals

Microsoft Excel

Microsoft Word

Educación

High school diploma or equivalent

California Pharmacy Technician license (preferred)

Herramientas

Microsoft Excel

Microsoft Word

Descripción del empleo

Western Growers is seeking a Prior Authorization (PA) Specialist to support the clinical pharmacy program by initiating, processing, and tracking PA requests to ensure timely access to therapy.

The role involves gathering and verifying required clinical documentation, communicating with prescribers, payers, and internal stakeholders, and maintaining accurate records in pharmacy systems and payer portals in a HIPAA-compliant manner.