Navitus Health SolutionsNS

Specialist I, Prior Authorization-Lumicera

Navitus Health Solutions is a pharmacy benefit manager (PBM) founded in 2003 with a mission to make prescription medications more affordable through a transparent, 100% pass-through model. They serve nearly 18 million members across almost 800 clients.

Navitus Health Solutions

Employee count: 1001-5000

Salary: 36k-42k USD

United States only

Company

Lumicera

About Us

Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.

Pay Range

USD $18.67 - USD $21.96 /Hr.

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am-7pm, CDT

Remote Work Notification

ATTENTION: Lumicera is unable to offer remote work to residents of Alabama, Alaska, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.

Overview

Due to growth we are adding a Prior Authorization Specialist to our team!

Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization Specialist I is primarily responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Prior Authorization Specialist’s main objective is to answer phone calls and contact the doctors and patients via fax or phone or other communication means to facilitate and document prior authorization approval. The Prior Authorization Specialist may also be responsible for ensuring that all pertinent patient information is contained within the record. Patient information shall include demographics, allergies, medication history, comorbidities, and payer information. This position will function with and assist any other area in the facility as needed with regard to prior authorization type duties.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

  • Responsible for answering the inbound calls from patients, prescribers, and other healthcare professionals
  • Responsible for contacting doctors to obtain necessary information
  • Responsible for managing the assigned workflow queues
  • Responsible for accurate and thorough documentation of information and prescription order set up
  • The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee
  • Other duties as assigned

Qualifications

What our team expects from you?

  • High school diploma or GED
  • Some college preferred
  • CPhT Preferred
  • Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure
  • Minimum two years pharmacy support experience or healthcare environment experience preferred
  • Ability to work scheduled hours, shifts may vary based on department needs. Hours of operation are 8am to 7pm Monday thru Thursday and 8am to 6pm on Friday
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Lumicera? • Top of the industry benefits for Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account

Location : Address

Remote

Location : Country

US

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Entry-level

Salary

Salary: 36k-42k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Navitus Health Solutions

Learn more about Navitus Health Solutions and their company culture.

View company profile

We are Navitus Health Solutions, and for more than two decades, we've been dedicated to transforming the pharmacy benefit management (PBM) landscape. Founded in 2003, our core belief was that the traditional PBM model needed a fundamental shift to better serve the interests of plan sponsors and their members. This conviction led us to pioneer a 100% pass-through business model, a transparent approach designed to eliminate unnecessary costs and ensure that all negotiated rebates, discounts, and fees are returned directly to our clients. We're driven by a profound commitment to helping people access the medications they need at more affordable prices, ultimately enabling them to lead fuller lives.

Our journey began with a vision to disrupt the industry norms and establish a new standard for financial and operational transparency in pharmacy benefits. We're proud to have consistently upheld this unique model, which stands in contrast to other established PBMs. Our purpose is clear: to humanize the pharmacy benefit experience and to relentlessly pursue strategies that lower overall drug spend and the cost of care. We achieve this by providing full financial and operational disclosures, improving medication adherence, and offering alternative treatment options that can reduce long-term drug reliance. We proudly serve almost 18 million members through nearly 800 clients, a testament to the trust placed in our approach. Our mission is to make medications more affordable for those who need them, fostering a healthcare system where honesty and open communication build unwavering trust.

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Navitus Health Solutions

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Navitus Health Solutions hiring Specialist I, Prior Authorization-Lumicera • Remote (Work from Home) | Himalayas