Rockefeller Philanthropy Advisors is hiring a Prior Authorization Coordinator to manage and process medication authorization requests efficiently and accurately in a remote role. You’ll collaborate with clinical pharmacists, physicians, and healthcare partners to ensure high-quality, timely decision-making that supports patient care and compliance.
What You'll Do
- Process prior authorization (PA) requests in compliance with client-specific guidelines and turnaround times.
- Enter and prioritize PA information, ensuring accuracy and adherence to performance guarantees.
- Investigate formulary alternatives, assess medication history, and use drug references to validate indications.
- Collaborate with clinical pharmacists, escalating cases that require medical decisions beyond administrative processing.
- Communicate with members, physicians, and pharmacies to gather missing details or clarify pending requests.
- Accurately document decisions, status updates, and communication trails.
- Identify process improvements and participate in quality initiatives and compliance programs.
- Maintain confidentiality and follow HIPAA protocols.
- Support feedback cycles and continuously improve performance.
What We're Looking For
- High school diploma or equivalent.
- Active Certified Pharmacy Technician license (state or national).
- Strong understanding of medication and disease states within pharmacy practice scope.
- High computer literacy (Microsoft Word, Excel, Adobe) and data entry proficiency.
- Excellent organizational, communication, and critical thinking skills.
- Proven ability to prioritize, meet deadlines, and handle multiple tasks simultaneously in a remote work setting.
- Strong customer service orientation with professional written and verbal communication.
Nice to Have
- At least 1 year of prior authorization experience.
- Experience in a health plan or Pharmacy Benefit Manager setting.
Technical Stack
- Microsoft Word
- Microsoft Excel
- Adobe
Team & Environment
You’ll collaborate with clinical pharmacists, physicians, and healthcare partners.
Benefits & Compensation
- Competitive salary based on experience.
- Remote work flexibility with equipment reimbursement.
- Comprehensive health, dental, and vision insurance.
- Generous paid vacation, sick leave, and paid holidays.
- 401(k) plan with company match.
- Ongoing training, growth opportunities, and employee recognition programs.
- Supportive team culture and compliance-focused environment.
Work Mode
This is a fully remote position, open to candidates located in the United States.
Rockefeller Philanthropy Advisors is an equal opportunity employer.
