Pharmacy Prior Authorization Coordinator I

As a Pharmacy Prior Authorization Coordinator I at Sentara Health, you'll be responsible for handling member and provider requests related to pharmacy benefits and prior authorizations, as well as resolving claims issues. You'll utilize our pharmacy computer system to facilitate these authorizations, ensuring efficient responses to inquiries while participating in essential patient and provider care activities.

To qualify for the Pharmacy Prior Authorization Coordinator I position at Sentara Health, you need to have a High School diploma or equivalent and be a Certified Pharmacy Technician (CPhT). It's also essential to possess at least one year of pharmacy experience in a call center or authorization setting, preferably within managed care or health plans. State registration is also required based on your location in Virginia or North Carolina.

Sentara Health offers a comprehensive benefits package for the Pharmacy Prior Authorization Coordinator I role, which includes medical, dental, and vision coverage, generous paid annual leave, tuition reimbursement, a 401a/401k/403b plan, and both long and short-term disability insurance. We also promote employee recognition and provide various work/life balance perks.

Key skills for the Pharmacy Prior Authorization Coordinator I at Sentara Health include strong communication and problem-solving abilities, attention to detail, and proficiency in pharmacy computer systems. Experience in a call center environment and knowledge of pharmacy benefits and authorizations will significantly contribute to your success in this position.

Sentara Health is committed to fostering a culture of growth and development. For Pharmacy Prior Authorization Coordinator I employees, opportunities for career advancement are plentiful, with access to training programs, professional certifications, and leadership development that will enhance your skills and career trajectory in the healthcare field.

When answering this question, provide specific examples of your past roles, such as your responsibilities and the processes you followed for prior authorizations. Highlight any pertinent software or systems you used, along with situations where you successfully resolved complex authorization requests.

To effectively answer this question, emphasize your attention to detail and organizational skills. Discuss methods you use to double-check entries, stay updated on pharmacy policies, and communicate clearly with team members to minimize errors in claim processing.

Showcase your customer service skills by outlining your approach to conflict resolution. Explain how you would listen to their concerns, provide clear information about the authorization process, and suggest next steps to resolve the issue, all while maintaining professionalism and empathy.

Highlight the importance of adaptability and problem-solving skills. Indicate that challenges may arise from changes in healthcare regulations or complex patient needs, and express your enthusiasm for addressing these challenges head-on to ensure quality patient care.

Provide examples of pharmacy software you've used in your previous roles, discussing how you navigated these systems to process authorizations accurately. Mention any relevant training or certifications related to these systems to show your proficiency.

Explain your strategy for time management, such as using a task list or software tools to organize and prioritize urgent requests. Emphasize your ability to remain calm and focused under pressure, ensuring that all tasks are completed timely and efficiently.

Research and articulate Sentara Health's core values and mission statement in your answer, demonstrating your understanding of their commitment to improving health every day. Mention specific initiatives or programs that resonate with you and align with your professional values.

Share your passion for helping patients navigate the healthcare system and ensuring they receive the medications they need. Discuss your long-term career goals in pharmacy and how this role aligns with those aspirations.

Talk about specific resources you utilize, such as professional networks, continuing education, or relevant publications that help you stay updated on industry changes and their implications for pharmacy operations.

Express your commitment to teamwork by describing your approach to collaboration and mentorship. Discuss how you would offer assistance, share resources, and maintain open communication to help them manage their tasks effectively.