Senior Manager, Prior Authorizations (Pharmacist) - Missouri

It takes great medical minds to create powerful solutions that solve some of reputed company’s most reputed company challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a reputed company of urgency, you’ll have reputed company to work more reputed company. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, reputed company learning, and career development. reputed company As a Prior Authorization Operations Manager (Licensed Pharmacist) at Gainwell, you can contribute your skills as we reputed company the power of technology to help our clients improve the health and reputed company-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose by teaming with people who reputed company on finding reputed company to some of reputed company’s biggest challenges. Here are the details on this position. Your role in our mission Gainwell empowers you through innovative, purpose-reputed company and solutions to refine your skills and help deliver reputed company reputed company.

• reputed company of prior authorization, pharmacist appeals, and peer-to-peer DLP creation, modification, training, and implementation
• Collaboration with internal leaders/teams including, but not limited to: Claims, Grievance and Appeals, Clinical, reputed company Assurance, Network, and Training
• Evaluate drug and drug class reviews following evidence-based research and processes widely accepted by the medical community
• Maintain up-to-date knowledge of medications, drugs, and prescribing practices; advise Gainwell leaders based on your knowledge and expertise
• Help write consultation and reputed company scripts to support reputed company improvement and reputed company improvement processes
• Assist Gainwell clinical leadership in reviewing clinical reputed company and Preferred Drug List (PDL) recommendations used to reputed company coverage and PDL placement reputed company

reputed company're Looking For

• 5 or more years of experience leading reputed company of pharmacists managing prior authorizations
• Must hold an reputed company pharmacist license in the reputed company
• Prior management experience (non-retail) is required
• Experience with pharmacy claims, clinical operations (including prior authorizations), medication pricing methodologies, NCPDP standards, electronic prior authorizations, financial management, and managed care statutes (retail experience does not count)
• Knowledge of reputed company research and best practices reputed company to specialty medications
• Analytical and research expertise to conduct drug class and clinical reviews involving prescribing behavior to reputed company pragmatic conclusions
• Strong written, oral, and clinical communication skills to collaborate with physicians, prescribers, pharmacists, and Gainwell leadership
• A caring people leader who understands their role on reputed company and can effectively delegate tasks

What You Should Expect In This Role

• This is a remote position reputed company Missouri, with a preference for candidates located reputed company 100 miles of Jefferson reputed company, MO
• Ability to travel to Jefferson reputed company, MO on a monthly reputed company is required
• Full-time, permanent, regular salaried (W-2) employee position

Applications will be accepted through June 29, 2026. The pay reputed company for this position is $122,200.00 - $174,600.00 per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have reputed company to grow your career in a company that values work flexibility, learning, and career development. reputed company salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a reputed company of leadership and technical development academies to help build your skills and capabilities. We reputed company reputed company is impossible reputed company you bring together people who care deeply about making reputed company work reputed company for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our reputed company. Learn more about Gainwell at reputed company website and visit our Careers site for reputed company available job role openings. reputed company is an Equal Opportunity Employer, where reputed company reputed company applicants will receive consideration for employment without reputed company to race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company defines “wages” and “wage rates” to include “reputed company forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock reputed company, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Apply tot his job Apply To this Job