Specialist III, Prior Authorization

🕒 October 9

🏈 Alabama, Arizona, +25 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote ⚜️ Louisiana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ⚔️ Virginia – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $21 - $25 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.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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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

📋 Description

• Coordinate and direct day-to-day operations of the Prior Authorization team • Support and foster team success through subject matter expertise and coaching • Assist with obtaining information and triaging prior authorizations for specialty pharmacy patients • Solve operational challenges and serve as a point of contact for escalations • Educate and assist other Lumicera areas with prior authorization duties • Cultivate an engaging, supportive, positive, and forward-thinking team environment • Assign daily tasks, provide guidance on complex problem-solving, and drive accountability for team KPI goals • Train new and existing Prior Authorization Specialists on core responsibilities, systems, phone platforms, documentation, and communication • Identify and present workflow and process improvement opportunities • Provide daily support regarding protocols, workflows, information dissemination, and operations questions • Assist with prior authorization phones and work queues for patients, prescribers, and healthcare professionals • Participate in compliance and diversity, equity, and inclusion program objectives • Perform other duties as assigned

🎯 Requirements

• 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 • Remote work available only 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

🏖️ Benefits

• 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!

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