Pharmacy Prior Authorization Team Lead

Job Description

Location: Remote – U.S. Eastern Time Zone

We are seeking a Prior Authorization Team Lead to manage a team of prior authorization specialists while maintaining a personal caseload of complex or escalated cases. This role supports specialty pharmacy operations by driving team performance, improving authorization workflows, and helping patients access specialty medications without unnecessary delays.

This role is best aligned for someone who has mastered the prior authorization process and is ready to lead a team that handles high-volume, payer-driven work at scale. The ideal candidate can coach specialists through complex cases, manage key performance metrics, and build workflows that keep medications moving from prescriber to patient.

Responsibilities:

• Supervise and mentor a team of prior authorization specialists handling specialty and high-cost medication authorizations
• Monitor team productivity metrics including turnaround times, approval rates, and appeals outcomes
• Manage a personal caseload of complex or escalated prior authorization cases requiring clinical documentation support
• Develop and update workflows for authorization intake, submission, follow-up, and appeals processes
• Train new hires on payer portal navigation, documentation requirements, and escalation protocols
• Collaborate with clinical pharmacists and prescribers to strengthen authorization submissions
• Track payer policy changes and formulary updates that impact authorization requirements
• Prepare performance reports and present team metrics to pharmacy leadership
• Conduct quality audits on authorization submissions and provide coaching feedback to team members
• Coordinate with hub services, patient access, and fulfillment teams on authorization status and patient communication
• Identify workflow bottlenecks and implement process improvements to reduce authorization cycle times
• Serve as the escalation point for payer disputes, urgent authorization needs, and high-priority patient cases

Qualifications:

• Associate degree required; bachelor’s degree in healthcare or pharmacy preferred
• CPhT certification required
• Minimum of 3 years of prior authorization experience in specialty pharmacy required
• Minimum of 1 year of lead, supervisory, or team training experience required
• Strong knowledge of specialty drug prior authorization processes across commercial, Medicare, and Medicaid payers
• Experience with pharmacy management systems, CRM platforms, and payer portals preferred
• Strong coaching, team development, and workload management skills
• Excellent communication skills for physician offices, payer contacts, and team leadership

Schedule:

• Full-time position
• Monday through Friday, 8:00 AM – 5:00 PM Eastern Time
• Standard full-time schedule of 40 hours per week

Salary Range: The salary range for this position is approximately $58,000 – $72,000 annually ($27.88 – $34.62 per hour), based on experience and qualifications.

Interview Process:

Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with department leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and a diverse, inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.