Prior Authorization Policy Lead - Clinical Criteria

TrueScripts Management Services, LLC; Washington, Northern (IN, KY); Hybrid; USD 70,000 - 110,000; Full time

Benefits offered by this job

Health insurance

401k with company match

ESOP transition

Wellness program

Team-based culture

Charitable contributions

Job summary

TrueScripts Management Services is seeking a Pharmacist Policy Criteria Specialist to draft and refine prior authorization criteria for medications, guided by FDA labeling and clinical guidelines. You will work with pharmacists and the policy committee to ensure accuracy and alignment with current standards.

Join a team committed to integrity, transparency, and Amazing Care, with responsibilities spanning governance, testing, and state-specific requirements to support compliant, efficient prior

Qualifications

• Ability to interpret FDA labeling, guidelines, and drug literature.
• Excellent written policy drafting and cross-team communication skills.
• Strong research and analytical thinking to draft criteria.
• Proactive, detail-oriented with ability to manage multiple projects.

Responsibilities

• Draft clinical criteria policies for medications requiring prior authorization, per FDA labeling and guidelines.
• Perform initial quality checks on drafted content before pharmacist review.
• Use dashboards to identify medications needing updated criteria.
• Submit drafts for internal pharmacist review and policy committee approval.
• Maintain a master log of criteria, version history, and review cadence.
• Build and maintain PA-related forms and templates within the platform.

Skills

Research skills

Written communication

Organizational skills

Problem-solving

Attention to detail

Independent work

Education

High school diploma

Two-year degree preferred

Tools

Confluence

Microsoft Office 365

Job description

TrueScripts Management Services is seeking a Pharmacist Policy Criteria Specialist to draft and refine prior authorization criteria for medications, guided by FDA labeling and clinical guidelines. You will work with pharmacists and the policy committee to ensure accuracy and alignment with current standards.

Join a team committed to integrity, transparency, and Amazing Care, with responsibilities spanning governance, testing, and state-specific requirements to support compliant, efficient prior