Manager, Clinical Pharmacy for Prior Authorization- Remote

City/State

Work Shift

Overview:

Status: Full-time, permanent position (40 hours)

Work hours: 8am to 5pm EST, M-F

Location: This position is fully remote for candidates that live in the following states: VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY!

Job Description Summary

• This position will manage and coordinate clinical pharmacy programs, including formulary and utilization management, reporting, outcomes assessment, and regulatory requirements.

• This position will report to the VP, Pharmacy- Sentara Health Plans and will require close collaboration with other management in the pharmacy department, as well as coordination with the health services team.

• This position will also be required to analyze systems, programs, and resources to maximize their effectiveness.

• This position will lead our clinical prior authorization operations workflows including electronic prior authorization build and staff management of 15 direct reports (Clinical Pharmacists)

Education

• BLD - Bachelor's Level Degree in Pharmacy REQUIRED

Certification/Licensure

• Licensed in VA REQUIRED

Experience

• Pharmacist- 5 years experience REQUIRED

• Health Plan- 4 years experience REQUIRED

• Managed Care- 4 years experience REQUIRED

• Management- 1 year experience REQUIRED

• Pharmacy Benefit Manager- 4 years experience REQUIRED

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission "to improve health every day," this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.