Medication Prior Authorization Specialist

About Palmetto Primary Care Physicians

Palmetto Primary Care Physicians (PPCP) is the largest independent multi-specialty group practice in South Carolina. The group is comprised of over 100 clinical providers with a wide range of expertise in primary and specialty care including endocrinology, gastroenterology, neurology, psychiatry, audiology and physical therapy.

PPCP has proudly served patients since 1996 and is known for their innovative patient centered delivery model. The group was among one of the first practices to nationally establish a successful Patient Centered Medical Home Program and the first in South Carolina. Today PPCP offers a wide range of services, including a state-of-the-art urgent care clinic, imaging, diagnostics and labs.

To learn more about PPCP, visit www.PalmettoPrimaryCare.com

• Offer 401K with generous company match
• Medical, Dental, Vision Benefits
• Short Term and Long Term Disability Offered

Job Functions:

• Completes prior authorization requests for medication.
• Assures timely completion of all prior authorization requests with a goal of no longer than 72 hours turn-around time.
• Assists with medical necessity documentation to expedite approvals of medications and procedures.
• Collaborates with providers/payers/pharmacist/patients to assure appropriateness of medications/ procedures needing prior authorization and to reduce barriers to patient receiving quality patient care.
• Partners and collaborates with other departments cross functionally regarding prior- authorization and/or clinical care services.
• Adapts departmental plans and priorities to address business and operational challenges.
• Build effective and professional relationships with internal (PPCP) and external (community) providers.
• Attends all care coordination meetings.
• Other duties as assigned.

Position Qualifications:

• Education: GED or High School Diploma required
• Experience: Minimum of 2 years’ experience in a pharmacy setting preferred. Proficient PC skills including ECW and Microsoft Excel preferred.
• Licensure/Certification: Licensed Pharmacy Technician, State of SC certification

Job Summary:

Supports the organization’s mission, vision, and values by exhibiting compassion, integrity, accountability and excellence. Serves as a key member of the interdisciplinary patient care team, collaborating with providers, colleagues, patients, and family members to promote a patient-driven model of care that ensures the delivery of quality and cost-effective healthcare services.

EOE