Specialist III, Prior Authorization

Specialist III, Prior Authorization

Location: United States – Remote

Work Arrangement: 100% Remote

Eligible States: Arizona, Alabama, Arkansas, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, and Wisconsin

Employment Type: Full-time

Pay Range: $21.05–$25.06 per hour

Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m.

About Us

Lumicera Health Services, powered by Navitus, is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.

Current associates must use the SSO login option at Navitus Employee Careers to be considered for internal opportunities.

We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Overview

Due to growth, we are adding a Specialist III, Prior Authorization to our team.

Under direction from the Supervisor, Prior Authorization, and other leaders at Lumicera, the Specialist III, Prior Authorization is primarily responsible for coordinating and directing the day-to-day operations of the Prior Authorization team. This position will support and foster team success of the Prior Authorization Specialists through leading by example with subject matter expertise and coaching teammates.

Achieving success in this position will be represented by reaching team goals for key performance indicators, provider and patient satisfaction, and continual workflow improvement.

The Specialist III, Prior Authorization will also be responsible for assisting the team with obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy.

The Specialist III, Prior Authorization will solve problems in both overcoming challenges operationally while serving as a point of contact for other associates with escalations, with the goal of achieving the best outcomes for all parties.

This position will function with, educating and assisting other areas of Lumicera as needed related to prior authorization type duties.

Responsibilities

How Do I Make an Impact on My Team?

• Cultivate a dynamic team environment for the Prior Authorization team that is engaging, supportive, positive, and forward-thinking.

• Communicate effectively with the prior authorization team to assign daily tasks, provide guidance in complex problem-solving scenarios, and drive accountability on overall team key performance indicator goals.

• Serve as a trainer for new and existing Prior Authorization Specialists on core job responsibilities to fulfill the needs of the patient and providers related to prior authorizations. This may include, but is not limited to, RxVector, NCRX, Lighthouse, Banjo, CoverMyMeds, phone platforms, and proper documentation and communication.

• Identify and present opportunities for workflow and process improvement to the direct supervisor and/or Lumicera leadership.

• Provide daily support for new and established associates, including making sure they understand new protocols and workflows, assisting in the distribution of information, and answering day-to-day operational questions.

• Assist with prior authorization workflows when needed, including phones and work queues related to patients, prescribers, and other healthcare professionals.

• Participate in, adhere to, and support compliance and diversity, equity, and inclusion program objectives.

• Perform other duties as assigned.

Qualifications

What Our Team Expects From You

• High School Diploma or GED required.

• National CPhT and/or registration/licensure required per associate's residing state's requirements.

• 2+ years of pharmacy support experience or healthcare environment experience required.

• Participate in, adhere to, and support compliance program objectives.

• Ability to consistently interact cooperatively and respectfully with other employees.

What Can You Expect From Lumicera?

• Top-of-the-industry health, dental, and vision insurance.

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

• 401(k) company match of up to 5%, with no vesting requirement.

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and professional membership assistance.

• Referral Bonus Program – up to $750.