Team Lead, Prior Authorization

Founded in 2019 and headquartered in Pittsburgh, PA, Free Market Health supports forward-thinking payers and specialty pharmacies of all sizes who need to operate in a complex and opaque market. We empower all stakeholders to optimize resources and maximize opportunities while focusing on the most important stakeholder of all: the patient.

Overview

We are seeking an experienced and motivated Team Lead to oversee a team of 4–5 Prior Authorization Specialists within our specialty pharmacy services department. This role requires strong leadership skills, critical thinking, and the ability to manage people, processes, and priorities to ensure patients and prescriber offices receive timely, efficient, and accurate support.
As a salaried, exempt role, the Team Lead is responsible for planning and directing the daily workflow of the team, resolving escalated issues, and driving continuous improvement in prior authorization processes. This position requires sound judgment, independent decision-making, and professional communication with both internal and external stakeholders.
The Team Lead is based onsite at our Pittsburgh headquarters, Monday through Friday, with occasional travel to local sites within a 25-mile radius.

What you will do:

• In person/onsite work in FMH Facility required
• Leadership & Team Management – Directly supervise, coach, and develop a team of 4–5 Prior Authorization Specialists, including assigning and overseeing daily work, managing day to day performance of team and escalating issues to staffing agencies. Serve as the Subject Matter Expert, providing guidance and handling escalations and complex cases. Responsible for training and onboarding new teammates. Engaging technology solutions and third party sites to facilitate case support and progress.
• Process Oversight & Improvement– Establish and maintain efficient workflows for benefit verification and prior authorization case handling. Identify areas for improvement and recommend process changes to leadership.
• Prescriber Office & Insurance Collaboration – Engage with offices and oversee communications with prescribers and insurance payers to ensure efficient, professional communication.
• Technology & Compliance– Ensure team compliance with internal systems, evolving technologies, and regulatory requirements, including HIPAA and company policies.
• Problem Solving, Escalation Management and Complex, Tier 3 Workload – Use discretion and independent judgment to resolve complex or sensitive issues, escalating to senior leadership only when appropriate.

What we need from you:

• High school diploma required; post-secondary education/degree highly desired. Nationally recognized Pharmacy Technician Certification required
• 5+ years of specialty pharmacy experience with prior authorization and benefit verification required, including at least 2 years of supervisory, lead, or management experience.
• Knowledge of drug nomenclature, medical terminology, insurance navigation, and prior authorization processes. Strong leadership and people management skills. Excellent written and verbal communication. Ability to adapt to new technology quickly.
• Strong organizational and problem-solving skills, ability to manage multiple priorities, and a track record of driving team success.
• Competencies: Leadership and team development, Independent judgment and decision-making, strong communication and customer service orientation, process improvement mindset, critical thinking and problem-solving

Physical Requirements: 

Working within an office environment, with or without an accommodation, and being able to carry a laptop to/from the office.  Employee must work onsite Monday through Friday, during business hours is essential to this position – no remote work will be permitted for this role.

Note:  All positions at Free Market Health require strict adherence to our security policies and compliance requirements.