Top 9 Prior authorization pharmacist Jobs in San Jose, Ca

Pharmacy Coordinator
Santa Clara Family Health Plan —San Jose, CA
- $61,554 - $89,253 a year
- Full-time
- Microsoft Outlook
- Mid-level
- Office
Quick Apply
Temp Pharmacy Coordinator
Santa Clara Family Health Plan —San Jose, CA
- $61,554 - $89,253 a year
- Temporary
- Microsoft Outlook
- Writing skills
- Mid-level
Clinical Product & Operations Lead Pharmacist
Develop Health —Menlo Park, CA
- $170,000 - $220,000 a year
- Full-time
- Hybrid work
- Office
- 3 years
- Supervising experience
- Health insurance
- Dental insurance
4d
Oncology Clinical Pharmacy Specialist
Shields Health Solutions —San Jose, CA
- $69.71 - $86.53 an hour
- Microsoft Outlook
- Outpatient experience
- 3 years
- Paid parental leave
- Paid holidays
Quick Apply
Relief Clinical Pharmacist I
Lucile Packard Children's Hospital Stanford —Palo Alto, CA
- $82.10 - $101.63 an hour
- Part-time
- Acute care
- Anatomy knowledge
- BLS Certification
Pharmacist - Part Time/Per Diem
Apotheco, LLC —Pleasanton, CA
- $67 - $70 an hour
- Part-time
- Microsoft Excel
- Microsoft Outlook
- Ability to walk for extended periods
Quick Apply
9d
Licensed Pharmacy Technician (Flexible Hours, Part-Time)
Q-Bit Wellness —Sunnyvale, CA
- From $19.50 an hour
- Part-time
- Background check
- BLS Certification
- High school diploma or GED
- Free parking
- Flexible schedule
Quick Apply

More jobs to discover

Find similar jobs that you might be interested in.

Temp Pharmacy Coordinator
Santa Clara Family Health Plan —San Jose, CA
Ability to effectively use telephone systems to place and receive calls in a professional manner. Performs non-clinical duties such as preparing departmental…
$61,554 - $89,253 a year
Temp Grievance and Appeals Coordinator
Santa Clara Family Health Plan —San Jose, CA
Maintain case files by ensuring that they are documented in accordance with state and federal requirements and organized in a manner that adheres to SCFHP…
$67,863 - $101,795 a year
7d

Show more similar jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Prior Authorization Specialist
Equitas Health, Inc. —Columbus, OH
Reliable transportation, driver’s license and proof of auto insurance required. Essential job functions include, but are not limited to, driving or having…
$18.13 - $21.78 an hour
Quick Apply
Specialty Pharmacy Intake Program Manager
OhioHealth —Canal Winchester, OH
Experience with multi-state pharmacy licensing and non-resident pharmacy compliance requirements. Experience building and leading front-end new referral…
3d

Show more jobs in cities nearby

I want to receive the latest job alert for prior authorization pharmacist in san jose, ca

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

prior authorization pharmacist jobs near san jose, ca

Pharmacy Manager jobs in San Jose, CA

Pharmacy Specialist jobs in San Jose, CA

Pharmacy Technician jobs in Sunnyvale, CA

Pharmacist jobs in Pleasanton, CA

Clinical Pharmacist jobs in Palo Alto, CA

Clinical Pharmacist jobs in Redlands, CA

Clinical Pharmacist jobs in Green Bay, WI

Clinical Pharmacist jobs in Egypt, AR

Clinical Coordinator jobs in Tampa, FL

Pharmacist jobs in Fort Lauderdale, FL

Clinical Pharmacist jobs in Glenview, IL

Pharmacy Manager jobs in Brockton, MA

Pharmacy Manager jobs in Seattle, WA

Pharmacy Manager jobs in Sherman, TX

Pharmacy Technician jobs in Bloomington, IN

Pharmacy Manager jobs in St. Louis, MO

Pharmacy Technician In Training jobs in Philadelphia, PA

Health Information Management Manager jobs in New York, NY

Healthcare Project Manager jobs in Austin, TX

Inventory Specialist jobs in Murfreesboro, TN

Pharmacy Coordinator

Santa Clara Family Health Plan -
San Jose, CA

Quick Apply

Job Details

Full-time
$61,554 - $89,253 a year

Qualifications

Computer operation
Pharmacy Technician License
PTCB Certification
High school diploma or GED
Telephone systems
Typing

Full Job Description

Salary Range: $61,554 - $89,253
The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change.

FLSA Status: Non-Exempt

Department: Pharmacy

Reports To: Supervisor, Prior Authorization

Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521

GENERAL DESCRIPTION OF POSITION

The Pharmacy Coordinator supports key operational, clinical, and regulatory functions across the pharmacy department. This role ensures timely processing of pharmacy-related requests, maintains compliance with regulatory requirements, supports quality and Stars initiatives, provides operational oversight of pharmacy benefit functions, and collaborates with internal teams to ensure members and providers receive accurate and efficient support.

ESSENTIAL DUTIES AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily.

1. Conduct daily review of denied pharmacy claims to ensure accuracy and identify trends and intervene as needed.

2. Perform telephonic member outreach to support Star Measures, including follow‑ups on denied PAs and medication refill reminders.

3. Support pharmacists by running, validating, and maintaining clinical program reports used for pharmacy quality initiatives.

4. Review UM authorization requests for diabetic testing supplies and continuous glucose monitors (CGM).

5. Support timely D-SNP Part D prior authorization effectuations.

6. Conduct quality assurance (QA) reviews to ensure accuracy for Medicare required marketing materials such as pharmacy network directory and formulary documents.

7. Review and support pharmacy grievance cases, ensuring timely resolution and compliance with regulatory timelines.

8. Provide responsive support to providers, Customer Service Representatives (CSR), and G&A teams regarding pharmacy operations and benefit inquiries.

9. Assist with various cross‑functional projects that enhance pharmacy operations, compliance, and member experience.

10. Perform other related duties as required or assigned.

REQUIREMENTS – Required (R) Desired (D)

The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.

1. High School Diploma or GED. (R)

2. Current and active Pharmacy Technician License without restriction in CA.

3. PTCB pharmacy certifications. (D)

4. Minimum two years of pharmacy experience in a managed care, hospital, long-term care, specialty compounding, infusion center, or retail pharmacy setting. (R)

5. Experience in health plan pharmacy operations, pharmacy benefits, prior authorization processes, and Medicare Part D preferred. (D)

6. Working knowledge of and the ability to efficiently operate all applicable computer software including Outlook Word, Excel and PBM web based platform and general office equipment. (R)

7. Proficient in MS Excel and reports. (D)

8. Ability to work independently with minimal supervision while consistently meeting deadlines and performance expectations. (R)

9. Ability to use a keyboard with moderate speed and a high level of accuracy. (R)

10. Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, members, providers and outside entities over the telephone, in person or in writing. (R)

11. Proficient in adapting to changing situations and efficiently alternating focus between tasks to support the operations as dictated by business needs. (R)

12. Ability to effectively use telephone systems to place and receive calls in a professional manner. (R)

13. Ability to maintain confidentiality and comply with all SCFHP policies and procedures. (R)

14. Ability to perform the job safely and with respect to others, to property and to individual safety. (R)

WORKING CONDITIONS

Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.

PHYSICAL REQUIREMENTS

Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:

Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R)
Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R)
Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R)
Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R)
Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R)

ENVIRONMENTAL CONDITIONS

General office conditions. May be exposed to moderate noise levels.

EOE

Quick Apply

Refine Your Search

prior authorization pharmacist jobs in san jose, ca

Pharmacy Coordinator

Temp Pharmacy Coordinator

Clinical Product & Operations Lead Pharmacist

Oncology Clinical Pharmacy Specialist

Relief Clinical Pharmacist I

Pharmacist - Part Time/Per Diem

Licensed Pharmacy Technician (Flexible Hours, Part-Time)

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for prior authorization pharmacist in san jose, ca

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected