Demo

Manager, Clinical Pharmacy (Prior Authorization)- Remote!

Sentara
Virginia, VA Remote Full Time
POSTED ON 2/14/2025
AVAILABLE BEFORE 4/14/2025

Sentara Health Plans is hiring for a Manager, Clinical Pharmacy (Prior Authorization)- Remote!

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)

Required qualifications:

  • Licensed in VA REQUIRED

  • 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

Benefits: Sentara offers an attractive array of full-time benefits to include

Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B , 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks and more.

Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met. 

 

For applicants within Washington State, the following hiring range will be applied:  $ 142,440.48 annually to  $ 196,560.00 annually.

Sentara Health Plans is the health insurance division of Sentara Healthcare.

Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

With more than 30 years’ experience in the insurance business and 20 years’ experience serving Medicaid populations, 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.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-72641

#LI-PM1

Talroo – Health Plan

Pharmacy, Managed Care, PharmD, Licensed Pharmacist, Virginia, MCO, Health Plan, Healthcare, Remote, Prior Authorization, Pre Auth,

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, Wyoming

Salary : $1,000 - $1,000,000

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