New Jersey Licensed Director of Prior Authorization
Job Summary
Overseeing EmpiRx Health's Prior Authorization and Appeals programs, the full-time, hybrid New Jersey Licensed Director of Prior Authorization will manage a team of pharmacists and technicians to ensure compliance, optimize workflows, and enhance clinical quality and member satisfaction.
Key Responsibilities:
- Lead and mentor a team to deliver efficient and compliant clinical review services
- Develop and implement standard operating procedures and policies in line with regulations
- Monitor performance metrics and identify process inefficiencies for continuous improvement
Required Qualifications:
- Bachelor of Pharmacy degree from an accredited institution
- Active Pharmacist License in good standing
- 5+ years of prior authorization experience within a PBM or health plan setting
- 10+ years of progressive management experience in healthcare or pharmacy operations
- Strong understanding of utilization management and appeals processing
Complete Job Description
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