Hiring: Director of Prior Authorization Company: EmpiRx Health Location: Greater Orlando Job Posted Time: 2026-09-03 11:22:51 Employment Type: Hybrid Target Skills & Keywords : Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Prior Authorization, Salesforce About the job Experience: •5+ years of prior authorization experience within a PBM or health plan setting. •10+ years of progressive management experience in healthcare or pharmacy operations. •In-depth knowledge of utilization management, formulary compliance, and appeals processing. •Advanced proficiency with Microsoft Office Suite (Excel, Word, PowerPoint) and pharmacy management systems. •Demonstrated ability to lead cross-functional teams, manage complex workflows, and deliver measurable outcomes. Required Skills: •Leadership and Team Management •Lead and mentor a team of Prior Authorization Pharmacists and Technicians to deliver efficient, compliant, and high-quality clinical review services. •Conduct performance evaluations, provide developmental feedback, and promote a collaborative, positive team culture. •Partner with the Vice President of Clinical Services to design and implement strategies that enhance prior authorization effectiveness and scalability. •Develop, implement, and maintain standard operating procedures (SOPs) and policies that comply with federal, state, and PBM regulations. •Educate staff on changes in healthcare policy, pharmacy regulations, and EmpiRx Health internal procedures. •Oversee clinical audits, ensure documentation accuracy, and lead corrective action initiatives as needed. •Maintain high-quality performance by auditing cases for accuracy, completeness, and adherence to review guidelines. Qualifications: •Degree from an accredited institution. Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!