Lead Pharmacy Prior Authorization Coordinator
BrightSpring Health Services
### Experience Required
None
### Minimum Education Required
High School Diploma/G.E.D.
### Compensation
$7.25 / hourly
### Hours Per Week
40
### Number Of Positions
1
### Work Schedule and Shift Requirements
First (Day)
### Job Description
Requisition: 2026-194671
Lead Pharmacy Prior Authorization Coordinator
Job Locations
US-KY-LOUISVILLE
ID 2026-194671 Line of Business PharMerica Position Type Full-Time
Our Company
PharMerica
Overview
Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!
Schedule: Mon-Fri(8:30am to 5pm)
This is a hybrid opportunity. Applicants must reside in, or commutable distance, to Louisville, KY
We offer:
DailyPay
Flexible schedules
Competitive pay
Shift differential
Health, dental, vision and life insurance benefits
Company paid STD and LTD
Tuition Assistance
Employee Discount Program
401k
Paid-time off
Tuition reimbursement
Non-retail/Closed-door environment
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
*Position will be posted for a minimum of 7 business days
Responsibilities
The Pharmacy Lead Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or coordinating with prescribers and/or facility contacts to have therapy changed to a preferred alternative due to insurance not covering the treatment in question. The Pharmacy Lead PA Coordinator also oversees new hire training completed by the Prior Authorization Coordinator II.
Helps manage staff appropriately and sets clear expectations for performance
Works with Billing Coordinator/Supervisor/Manager in researching pharmacy accounts requiring special attention
Assists Billing Coordinator/Supervisor/Manager in overseeing daily prior authorization activities per policies and procedures when necessary
Ensures appropriate, timely and professional communications occurs with Implementation team, Account Management team, Directors of Pharmacy, and Facility staff as needed
Audits prior authorization functions regularly for compliance to policies, procedures, contract and government regulations
Prioritizes and delegates job tasks to ensure timely completion
Follows all applicable government regulations including HIPAA
Participates in projects and/or management meetings
Addresses workflow and/or business issues while keeping direct manager informed
Participates on various prior authorization specific sub-groups to identify all attributes for best practice implementation and influences development of policies and procedures as well as identifies appropriate training material and educational opportunities
Implements proper prior authorization forms and forwards them to physicians to obtain approval
Completes change of therapy forms to facility contacts and physicians
Adjudicates claims, researching formularies for numerous insurance plans, contacting physician's office, updating spreadsheets on a daily basis, follow-up and obtain approval or denial of prior authorizations
Communicates timely and in a courteous manner to the physician/clinical staff regarding authorization status or delays
Oversees and approves updates made to the Prior Authorization Training Manuals by the Pharmacy Prior Authorization Coordinator II
Qualifications
High School Diploma/GED required
Pharmacy Tech License preferred
Excellent customer service and communication skills, both written and verbal
Ability to prioritize and meet pre-determined deadlines
Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
Experience in healthcare billing environment (pharmacy preferred)
Familiarization with online claims processing and Medicaid and Medicare billing practices
Proficient with Microsoft Word & Excel required
If a current PAL employee, you must:
Have 6+ months of prior authorization experience as PAL Core Prior Authorization Coordinator
Adhere to Pharmacy Alternatives, LLC attendance policy
Excel and adhere to core Pharmacy Alternative Prior Authorization responsibilities
Not be on any form of Performance Improvement/Corrective Action Plan
About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.
Res-Care, Inc., dba BrightSpring Health Services (“ResCare”), is an Equal Opportunity Employer. ResCare does not discriminate against any person on the basis of gender, r ace, color, national origin, r eligion, disability, age, veteran status, gender identity or s exual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.
### Job Type
Full time
### Benefits Offered
Not specified
### Veteran Preference
No
### Place of Work
On-site
### Requisition ID
2026-194671
Confirmar seu email: Enviar Email
Todos os Empregos de BrightSpring Health Services