Onco360 Oncology Pharmacy
Supervisor - Pharmacy Prior Authorization
Onco360 Oncology Pharmacy, Waltham, Massachusetts, United States, 02254
Onco360 Pharmacy
is seeking a qualified candidate to fill the role of
Pharmacy Prior Authorization Supervisor . This full‑time position (Monday‑Friday, 10:30‑7:00 pm or 11:30 am‑8:00 pm EST) offers an opportunity to support our expanding Specialty Pharmacy program and contribute to bettering the lives of those battling cancer and rare diseases.
Salary starts at $59 k and increases based on experience. Benefits include:
Medical, dental, and vision coverage
401(k) with matching contribution
Paid time off and paid holidays
Quarterly incentive bonuses
Tuition reimbursement
Company‑paid life insurance and short‑ and long‑term disability coverage
Essential Functions
Supervise prior authorization staff, fostering a positive work environment, teamwork, and employee retention.
Assist the Director of Pharmacy Operations with day‑to‑day pharmacy operations and implement new procedures to ensure accurate and timely dispensing of quality pharmacy services.
Recruit, hire, train, coach, and evaluate new associates; develop performance‑based corrective and disciplinary plans when needed.
Manage and report daily activity for the PA team, including workflow monitoring and Pulse reporting.
Provide timely responses to pharmacy operations, providers, and patients regarding prior authorization information.
Run test and live claims to verify payable claims or valid rejections, initiating PA requests with appropriate forms or CoverMyMeds.
Contact insurance companies to follow up on PA requests and document all PA information in the patient profile.
Offer guidance to providers and patients on documentation required for payer coverage, support appeals for denied claims, and coordinate follow‑up.
Handle escalations for complex claim rejection cases to ensure accurate adjudication.
Provide ongoing training and frontline support for PA team members on web tools and system functionality.
Collaborate with the Prior Authorization Manager and/or Director of Pharmacy Operations on projects, implementations, and initiatives as required.
Maintain a safe, clean pharmacy and comply with professional practice, confidentiality laws, and regulatory requirements.
Contribute to team effort by completing related tasks and other duties as assigned.
Qualifications Education & Learning Experience
Required:
High School Diploma or GED; prior pharmacy and prior authorization experience.
Desired:
Associate’s or Bachelor’s degree; Certified Pharmacy Technician (PTCB); specialty pharmacy experience.
Work Experience
Required:
4+ years in pharmacy or prior authorization, with previous leadership experience.
Desired:
5+ years in pharmacy or prior authorization, 1+ years Supervisor experience, specialty pharmacy background.
Skills & Knowledge
Required:
Deep knowledge of the prior authorization process, CoverMyMeds and other platforms, insurance forms, pharmacy claim processing (Medicare, Medicaid, commercial), NCPDP claim rejection resolution, medication billing, terminology, math, and analytical skills.
Desired:
Specialty pharmacy operations, leadership skills, independent decision‑making, research ability, resourcefulness, self‑reliance, excellent communication skills.
Licenses & Certifications
Required:
Registration with the Board of Pharmacy as required by state law.
Desired:
Certified Pharmacy Technician (PTCB); Advanced Certified Pharmacy Technician with Billing and Reimbursement certification.
Behavior Competencies
Independent worker with strong interpersonal skills, excellent verbal and written communication, ability to work autonomously and meet deadlines, attention to detail, time‑management, and leadership.
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is seeking a qualified candidate to fill the role of
Pharmacy Prior Authorization Supervisor . This full‑time position (Monday‑Friday, 10:30‑7:00 pm or 11:30 am‑8:00 pm EST) offers an opportunity to support our expanding Specialty Pharmacy program and contribute to bettering the lives of those battling cancer and rare diseases.
Salary starts at $59 k and increases based on experience. Benefits include:
Medical, dental, and vision coverage
401(k) with matching contribution
Paid time off and paid holidays
Quarterly incentive bonuses
Tuition reimbursement
Company‑paid life insurance and short‑ and long‑term disability coverage
Essential Functions
Supervise prior authorization staff, fostering a positive work environment, teamwork, and employee retention.
Assist the Director of Pharmacy Operations with day‑to‑day pharmacy operations and implement new procedures to ensure accurate and timely dispensing of quality pharmacy services.
Recruit, hire, train, coach, and evaluate new associates; develop performance‑based corrective and disciplinary plans when needed.
Manage and report daily activity for the PA team, including workflow monitoring and Pulse reporting.
Provide timely responses to pharmacy operations, providers, and patients regarding prior authorization information.
Run test and live claims to verify payable claims or valid rejections, initiating PA requests with appropriate forms or CoverMyMeds.
Contact insurance companies to follow up on PA requests and document all PA information in the patient profile.
Offer guidance to providers and patients on documentation required for payer coverage, support appeals for denied claims, and coordinate follow‑up.
Handle escalations for complex claim rejection cases to ensure accurate adjudication.
Provide ongoing training and frontline support for PA team members on web tools and system functionality.
Collaborate with the Prior Authorization Manager and/or Director of Pharmacy Operations on projects, implementations, and initiatives as required.
Maintain a safe, clean pharmacy and comply with professional practice, confidentiality laws, and regulatory requirements.
Contribute to team effort by completing related tasks and other duties as assigned.
Qualifications Education & Learning Experience
Required:
High School Diploma or GED; prior pharmacy and prior authorization experience.
Desired:
Associate’s or Bachelor’s degree; Certified Pharmacy Technician (PTCB); specialty pharmacy experience.
Work Experience
Required:
4+ years in pharmacy or prior authorization, with previous leadership experience.
Desired:
5+ years in pharmacy or prior authorization, 1+ years Supervisor experience, specialty pharmacy background.
Skills & Knowledge
Required:
Deep knowledge of the prior authorization process, CoverMyMeds and other platforms, insurance forms, pharmacy claim processing (Medicare, Medicaid, commercial), NCPDP claim rejection resolution, medication billing, terminology, math, and analytical skills.
Desired:
Specialty pharmacy operations, leadership skills, independent decision‑making, research ability, resourcefulness, self‑reliance, excellent communication skills.
Licenses & Certifications
Required:
Registration with the Board of Pharmacy as required by state law.
Desired:
Certified Pharmacy Technician (PTCB); Advanced Certified Pharmacy Technician with Billing and Reimbursement certification.
Behavior Competencies
Independent worker with strong interpersonal skills, excellent verbal and written communication, ability to work autonomously and meet deadlines, attention to detail, time‑management, and leadership.
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