Specialist III, Prior Authorization

Company Lumicera

About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services 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 SSO login option at https://employees-navitus.icims.com/ 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.

Pay Range USD $21.05 - USD $25.06 /Hr.

STAR Bonus % (At Risk Maximum) 0.00 - Ineligible

Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm

Remote Work Notification ATTENTION: Lumicera is only able to offer remote work to residents of 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, Wisconsin

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.

Is this you? Find out more below!

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 not limited to, RxVector, NCRX, Lighthouse, Banjo, Cover My Meds, phone platforms and proper documentation and communication

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

Provide daily support for new and established associates, i.e. making sure they understand new protocols, workflows, assist in the promulgation of information, answering day-to-day operations questions

Responsible for assisting in prior authorization workflow when needed with 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

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 pharmacy support experience or healthcare environment experience required

Participate in, adhere to, and support compliance program objectives

The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Lumicera?

Top of the industry benefits for Health, Dental, and Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match of up to 5% - No vesting requirement

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Professional Membership assistance

Referral Bonus Program – up to $750!

#LI-Remote

Location : Address Remote

Location : Country US