Remote Lead, Pharmacy Authorization Specialist 4

Washington State Health Care Authority; Olympia (WA); Remote; USD 76,000 - 98,000; Full time

Benefits offered by this job

Remote work flexibility

Medical, dental, vision insurance

Paid vacation and sick leave

PFML benefits

Retirement options

Job summary

Washington State Health Care Authority seeks a Medical Assistance Specialist 4 – Internal to lead a MAS team handling pharmacy authorizations, assist with complex questions, and train staff on processes. The role involves liaising with Apple Health staff and other departments to ensure high-quality outcomes.

The position is remote, full-time, with occasional in-person meetings. Requires expertise in Medicaid-related programs, policy interpretation, and staff leadership to maintain program

Qualifications

• Mentioned knowledge of federal/state laws, regulations, and program requirements.
• Ability to analyze complex program issues and provide informed determinations.
• Experience leading, guiding, and coaching staff on complex workflows.

Responsibilities

• Lead quality control within Pharmacy Authorization Unit to ensure proper protocols.
• Trains MAS3s to case manage pharmaceutical requests.
• Assist supervisor and MAS3s in reviewing complex pharmacy authorizations.
• Consult with management on policies, procedures, and workflows.
• Respond to online inquiries about authorizations and policies.
• Utilize Provider One, CRM, FlexRx, Right Fax, and Drug Rolodex for accuracy.
• Monitor providers deviating from standards for compliance.

Skills

Advanced Medical Assistance Program

Advanced Analysis & Problem Resolution

Technical Leadership & Guidance

Training & Knowledge Transfer

Quality Assurance & Program Consis t

Policy & Regulatory Interpretation

Equity & Inclusion mindset

Continuous learning & growth

Education

Bachelor's degree or higher

Experience in health benefits or Medicaid related work

Tools

Provider One

CRM

FlexRx

Right Fax

Drug Rolodex

Job description

Washington State Health Care Authority seeks a Medical Assistance Specialist 4 – Internal to lead a MAS team handling pharmacy authorizations, assist with complex questions, and train staff on processes. The role involves liaising with Apple Health staff and other departments to ensure high-quality outcomes.

The position is remote, full-time, with occasional in-person meetings. Requires expertise in Medicaid-related programs, policy interpretation, and staff leadership to maintain program