Prior Authorization Manager

Prior Authorization Manager

Fully Remote Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL 33309

Overview

Position Type Full Time Category Admin - Clerical

Description

WHO WE ARE At Polaris Pharmacy Services, we're more than a pharmacy we're a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.

Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job we provide competitive pay, robust benefits, and genuine opportunities for career advancement.

If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.

JOB SUMMARY:

The Manager of Prior Authorization at Polaris Pharmacy Services is responsible for overseeing and managing the prior authorization process to ensure timely and accurate processing of medication requests. This role is crucial in maintaining compliance with healthcare regulations, optimizing workflow efficiency, and enhancing patient satisfaction by ensuring access to necessary medications.

DUTIES/RESPONSIBILITIES:

• Lead and manage the prior authorization team, providing guidance, support, and training to ensure high performance and adherence to company standards.
• Develop and implement policies and procedures to streamline the prior authorization process, ensuring compliance with regulatory requirements and industry best practices.
• Monitor and analyze prior authorization metrics to identify areas for improvement and implement strategies to enhance efficiency and accuracy.
• Collaborate with healthcare providers, insurance companies, and internal departments to resolve issues and facilitate the approval of medication requests.
• Maintain up-to-date knowledge of healthcare regulations, insurance policies, and medication formularies to ensure compliance and provide accurate information to stakeholders.
• Prepare and present reports on prior authorization activities, performance metrics, and improvement initiatives to senior management.
• Foster a positive and collaborative work environment, promoting teamwork and effective communication within the prior authorization team and across the organization.

Qualifications

QUALIFICATIONS/COMPETENCIES:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

REQUIRED SKILLS/ABILITIES:

• Strong knowledge of healthcare regulations and compliance related to prior authorizations.
• Excellent leadership and team management skills with the ability to motivate and develop staff.
• Proficient in data analysis and reporting to track performance metrics and identify areas for improvement.
• Exceptional communication and interpersonal skills to effectively collaborate with healthcare providers, insurance companies, and internal teams. Ability to manage multiple priorities in a fast-paced environment with strong organizational skills.
• Proficiency in using pharmacy management software and other relevant healthcare information systems.

EDUCATION and/or EXPERIENCE:

• Bachelor's degree in Healthcare Administration, Pharmacy, Business Administration, or a related field.
• Minimum of 5 years of experience in a healthcare setting, with at least 3 years in a managerial or supervisory role.
• Proven experience in prior authorization processes within a pharmacy or healthcare environment.
• Demonstrated experience in process improvement and efficiency optimization in healthcare operations.

PHYSICAL DEMANDS

• May sit or stand seven (7) to ten (10) hours per day
• The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk
• May be necessary to work extended hours as needed
• May lift and/or move up to 30 pounds
• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

HOLIDAY & PTO POLICY

• Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.
• Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.
• Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.

Please note, because we are a pharmacy most of our locations are open 24-hours a day, 7 days a week and therefore schedules may change as determined by the needs of the business.

BENEFITS for full time Employees

• Medical, Dental, and Vision insurance
• 401 (k) (available for Part Time & Full Time EEs)
• Company Paid Life insurance
• Short-term and Long-term disability insurance
• Tuition reimbursement
• Personal Time Off (PTO)
• Competitive pay with annual performance reviews and merit-based raises
• Career growth potential
• Annual on-site voluntary Flu Vaccines
• Employee referral bonus program