Prior Authorization Pharmacist

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Liviniti

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2011

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

Liviniti is a pass-through pharmacy benefit manager (PBM) that helps employers and health systems reduce prescription drug costs through transparent pricing, clinical programs, and drug sourcing. The company offers 100% rebate pass-through, a flat administrative fee, access to claims and rebate details for full visibility, customizable formularies and networks, prior authorization focused on lowest net cost, and specialized solutions like LivLite for managing GLP‑1 weight-loss drugs. Liviniti emphasizes B2B service, clinical value, and continuous innovation to lower pharmacy spend while maintaining member support and service.

📋 Description

• Manage the day-to-day operation of the prior authorization team • Ensure authorizations are accurately obtained and reviewed in a timely manner • Manage assigned daily work queues within the PAHub prior authorization system • Navigate drug information resources, clinical guidelines, claim systems, and benefit design systems • Assist the manager with overseeing prior authorization technicians • Review and approve or deny pharmaceutical coverage based on guideline-based prior authorization criteria • Coordinate with the Clinical team, Account Management, and other stakeholders • Serve as a clinical resource to other pharmacists • Assist with developing or updating prior authorization criteria • Review prior authorizations to support client member medication access • Communicate approved process improvements to the team leader • Own assigned tasks, prioritize work, and complete projects in a timely manner • Participate in assigned projects and meetings • Complete training, research, and e-learning to remain current on best practices and practice management technology • Comply with HIPAA obligations regarding Protected Health Information • Report discovered HIPAA violations to the Compliance Officer and/or Human Resources • Complete required HIPAA training and demonstrate competency • No travel expected

🎯 Requirements

• Pharmacist license in good standing • Maintains continuation education requirements • BS Pharm OR PharmD required • Managed Care experience required • Prior authorization review experience required • Availability during core work hours of 8:00AM to 5:00PM CT • Ability to adjust work times to cover meetings in all time zones • Ability to work extended hours, weekends and holidays pursuant with industry demands • Past use of PAHub preferred

🏖️ Benefits

• Medical, Dental Vision Insurance • Disability and Life Insurance • Employee Assistance Program • Remote Work Options • Generous Paid-Time Off • Annual Reviews and Development Plans • Retirement Plan with company match immediately 100% vested