Utilization Management Supervisor: Prior Authorization Lead

Socket.dev; Charlotte (NC); Hybrid; USD 78,000 - 85,000; Full time

Job summary

Judi Health is seeking a dedicated Prior Authorization team lead to oversee a group of technicians and support utilization management initiatives. You will collaborate with pharmacy staff to optimize workflows, review cases for clinical guidelines, and coach team members to maintain quality and compliance in a fast-paced startup environment.

This role requires at least one year of PA/appeals experience, an active CPhT license, and strong Excel/PowerPoint skills.

Qualifications

• Active, unrestricted National Certified Pharmacy Technician (CPhT) license.
• 1 year of prior authorization and/or appeals experience.
• Strong communication, writing, and organizational skills.
• Proficient in Microsoft Excel and PowerPoint.
• Pharmacy clinical background required.
• Ability to multitask and collaborate in a team with shifting priorities.
• Ability to work in fast-paced startup environment with flexible schedules, including weekends.

Responsibilities

• Oversee a group of prior authorization technicians.
• Analyze data and advise on staffing and workflow.
• Coach and train utilization management pharmacy technicians.
• Review claims data for proactive outreach and intervention.
• Prepare prior authorization requests with clinical guidelines.
• Maintain quality and productivity while minimizing compliance risk.
• Triage inquiries from members, providers, and pharmacists.
• Ensure HIPAA compliance and customer satisfaction.

Skills

Prior Authorization

Effective communication

Organizational skills

MS Office

Pharmacy knowledge

Multi-tasking

Team coordination

Tools

Microsoft Excel

PowerPoint

Microsoft Office

Job description

Judi Health is seeking a dedicated Prior Authorization team lead to oversee a group of technicians and support utilization management initiatives. You will collaborate with pharmacy staff to optimize workflows, review cases for clinical guidelines, and coach team members to maintain quality and compliance in a fast-paced startup environment.

This role requires at least one year of PA/appeals experience, an active CPhT license, and strong Excel/PowerPoint skills.