Manager, Clinical Pharmacy for Prior Authorization- Remote

City/State

Work Shift

Overview:

Sentara Health Plans is hiring for a Manager, Clinical Pharmacy for 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)

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.