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

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

• 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

At BrightSpring Health Services, our LEGACY culture guides how we lead, how we serve, and how we show up for one another. We are committed to doing the right thing—leading with integrity, accountability, and transparency in all that we do. As part of this commitment, we share that we may use third-party artificial intelligence (AI) to process employment data in connection with our hiring processes. Any AI tool that we use always has humans in the loop; we do not use AI to automate employment decisions or to discriminate, and we do not use zip codes as proxy. Humans – our hiring leaders and recruiter – make final decisions. BrightSpring Health Services provides reasonable accommodations to qualified applicants and employees with disabilities; if you would like to request a reasonable accommodation, please contact your recruiter or send an inquiry to TalentAcquisition@brightspringhealth.com. For more information about how our company uses AI in the hiring process, contact TalentAcquisition@brightspringhealth.com.

BrightSpring Health Services and its affiliated companies provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

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Equal Opportunity Employment Posters

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