Pharmacy Utilization Lead (Non-Clinical / UM Systems)

AffirmedRx; United States; Remote; USD 55,000 - 85,000; Full time

Job summary

AffirmedRx is seeking a detail-oriented non-clinical administrator to lead pharmacy utilization management program administration. You will process prior authorization requests, ensure workflow compliance, and support regulatory adherence.

As a subject matter expert, you will coordinate workflows, provide training, oversee quality, resolve escalations, and serve as a super-user for UM technology to drive process improvements.

Responsibilities

• Leads non-clinical administration of pharmacy utilization management programs, processing prior authorization requests and ensuring compliance with workflows and regulations.
• Serves as a subject matter expert, overseeing workflow coordination, training, quality oversight, and resolution of non-clinical escalations.
• Acts as a super-user for UM technology, leading operational configuration, testing, and process improvements.

Job description

AffirmedRx is seeking a detail-oriented non-clinical administrator to lead pharmacy utilization management program administration. You will process prior authorization requests, ensure workflow compliance, and support regulatory adherence.

As a subject matter expert, you will coordinate workflows, provide training, oversee quality, resolve escalations, and serve as a super-user for UM technology to drive process improvements.