Prior Authorization Supervisor

Posted Yesterday
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Smyrna, GA, USA
Hybrid
Mid level
Healthtech
The Role
Supervise and provide clinical/operational oversight of prior authorization (PA) processes across lines of business. Manage PA Specialists/Technicians, review PA requests and appeals, support clinical calls, ensure regulatory and URAC compliance, prepare utilization reporting, and develop PA protocols and training.
Summary Generated by Built In
JOIN A LEADING HEALTHCARE COMPANY

At Curant Health, our vision is to personalize healthcare—driven by choice and defined by value. Our employees bring this vision to life through excellent service, personalized care, accountability, innovation, and integrity. We offer competitive pay, great benefits, and the opportunity to make a meaningful impact every day. We are seeking a Prior Authorization Supervisor in Smyrna, GA or St. Petersburg, FL to oversee clinical and operational Prior Authorization (PA) processes and ensure timely access to specialty medications.

Position Summary

The Prior Authorization Supervisor provides clinical and operational oversight for PA activities across Commercial, Medicaid, Medicare, and Co-op lines of business. This role directly supervises PA Specialists and Technicians in both locations, supports clinical calls, manages workflow, handles appeals, and ensures full compliance with regulatory and client requirements.

ResponsibilitiesOperational & Clinical Oversight
  • Oversee daily PA requests following established clinical criteria and benefit rules

  • Review initial PA requests, complete first-level appeals, and coordinate second-level appeals

  • Support Customer Care with medication-related clinical calls

  • Monitor accuracy, efficiency, and quality of coverage determinations

  • Serve as a clinical resource for internal teams, prescribers, and clients

  • Stay current on clinical guidelines and communicate updates

Reporting, Compliance & Program Support
  • Prepare and coordinate PA and drug-utilization reporting

  • Ensure compliance with regulatory, fraud, waste, and abuse requirements

  • Maintain understanding of URAC standards

  • Support rare disease program initiatives and manufacturer patient programs

Leadership & Department Management
  • Supervise PA Specialists and Technicians, including hiring, training, and performance reviews

  • Plan and direct daily PA operations across both locations

  • Manage department staffing, workload, and coverage

  • Identify and escalate operational issues appropriately

  • Develop and update PA protocols with Pharmacy Leadership

  • Foster strong communication across operational teams

  • Create and maintain training materials and support ongoing staff development

Qualifications
  • Advanced degree in Pharmacy with at least 3 years of experience

  • Active pharmacist license in applicable state

  • PA experience in pharmacy, PBM, or managed care required

  • Knowledge of formulary management, claims processing, managed care, and specialty pharmacy preferred

  • 340B experience is a plus

  • Strong clinical judgment, leadership ability, and communication skills

Why Work for Us?

We offer competitive pay, paid holidays, PTO, parental leave, employee prescription discounts, training and development, recognition programs, and internal promotion opportunities. Our ICARE values—Integrity, Communication, Accountability, Relationships, and Excellence—guide everything we do. Curant Health is an equal opportunity employer.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Skills Required

  • Advanced degree in Pharmacy
  • At least 3 years of relevant pharmacy experience
  • Active pharmacist license in applicable state
  • Prior authorization (PA) experience in pharmacy, PBM, or managed care
  • Knowledge of formulary management, claims processing, managed care, and specialty pharmacy
  • 340B program experience
  • Strong clinical judgment, leadership ability, and communication skills
  • Understanding of URAC standards and regulatory compliance
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The Company
HQ: Atlanta, GA
184 Employees
Year Founded: 2000

What We Do

Curant Health is an enhanced specialty pharmacy and outcomes-based patient support organization headquartered in the Atlanta area. At Curant Health, we focus on transforming the patient journey and providing consistent, improved outcomes through our unique, high-touch approach. Our transformational processes and programs provide chronic disease expertise and support to improve both the therapy experience and the quality of life for our patients. We improve patient health outcomes through our pharmacist-managed medication management program, and we provide comprehensive therapeutic monitoring and medication packaging designed to fit each patient's lifestyle. At Curant Health, our medication management approach brings the patient journey full circle through strong collaboration between the patient, healthcare providers and medication management experts. Visit us at www.curanthealth.com Twitter @curanthealth

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