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Manager Prior Authorization Jobs in Kentucky (NOW HIRING)

University of Rochester

$56.22/hr

Responsible for managing department referrals. Serves as liaison, appointment coordinator, and ... Prior authorization functionality required for testing and services ordered by referred to ...

Astera Cancer Care

$120 - $160/hr

Complete management of the prior authorization team* Hire new team members as necessary and manage the performance of all existing team members* Create and maintain a staffing model that adequately ...

NHSHP

$249 - $373/hr

Prior authorization, utilization management and claims review cases for patients * Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive ...

Tnafp

$249 - $373/hr

Prior authorization, utilization management and claims review cases for patients * Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive ...

ISHE

$249 - $373/hr

Prior authorization, utilization management and claims review cases for patients * Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive ...

Rhode Island Bar Assn.

$249 - $373/hr

Prior authorization, utilization management and claims review cases for patients * Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive ...

Devoted

$83 - $96/hr

Minimum 3 years of utilization management, utilization review, or prior authorization experience within a health plan, hospital, or post-acute setting. * Knowledge and understanding of CMS guidelines ...

Pediatrica

$90 - $130/hr

Prior Authorization Management * Manage pediatric prior authorizations, ensuring timely submission, follow-up, and approval in accordance with payer requirements. * Maintain current knowledge of ...

Boston Scientific Gruppe

$57 - $109/hr

Submit prior authorization requests to health plan as needed to assist the team achieving ... Manage and monitor payer trends as it relates to approvals/denials and communicate trends to the ...

Koya Medical, Inc.

$125 - $130/hr

Monitor and report key performance indicators (KPIs) such as team productivity, prior authorization ... requested by any Koya manager authorized to provide instruction or assign work. Duties ...

UNM HOSPITALS

$55 - $75/hr

POLICY & PROCEDURE - Develop and maintain policies and procedures for referral, prior authorization management and centralized scheduling * PROBLEM SOLVING - Troubleshoot and resolve referral and ...

BrightSpring

Medicare D Billing Representative

Louisville, KY · Remote

$15.75 - $20.25/hr

... Manager * Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions * Conducts job responsibilities in accordance with the standards set out in the ...

PharMerica

Medicare D Billing Representative

Louisville, KY · On-site +1

$15.75 - $20.25/hr

... Manager * Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions * Conducts job responsibilities in accordance with the standards set out in the ...

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All JobsPrior Authorization JobsManager Prior Authorization JobsManager Prior Authorization Jobs in Kentucky

Manager Prior Authorization information

See Kentucky salary details

$27.4K

$72.5K

$130.3K

How much do manager prior authorization jobs pay per year?

As of Sep 5, 2026, the average yearly pay for manager prior authorization in Kentucky is $72,506.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,200.00 and $89,500.00 per year, depending on experience, location, and employer.

What is a manager prior authorization?

A Manager of Prior Authorization oversees the authorization process for medical treatments, ensuring that required approvals are obtained from insurance providers. They manage a team handling prior authorization requests, review policies to ensure compliance, and work to optimize efficiency in approval processes. This role involves collaboration with healthcare providers, insurance companies, and patients to minimize delays in care. Strong leadership, knowledge of insurance guidelines, and experience in healthcare administration are essential for success in this position.

What are the key skills and qualifications needed to thrive as a manager prior authorization?

To excel as a Manager Prior Authorization, you need expertise in healthcare administration, insurance processes, and prior authorization protocols, usually demonstrated by a bachelor's degree in healthcare or related fields and relevant experience. Familiarity with healthcare management software, electronic medical records (EMR), and insurance authorization systems is highly valuable, and certifications like Certified Prior Authorization Specialist (CPAS) can be advantageous. Outstanding leadership, attention to detail, and effective communication are pivotal for managing teams and streamlining workflows. These skills and qualities ensure compliance, reduce delays in patient care, and improve overall operational efficiency within healthcare organizations.

What are some common challenges a manager prior authorization might face, and how are they addressed?

A Manager Prior Authorization often encounters challenges such as managing high volumes of authorization requests, staying updated with changing insurance requirements, and ensuring quick turnaround times to avoid delays in patient care. Addressing these issues typically involves implementing efficient workflows, training staff on the latest policies, and leveraging technology to automate repetitive tasks. Collaboration with physicians, payers, and internal departments is also key to resolving complex authorization cases. Proactive communication and continuous process improvement help maintain compliance and streamline the overall prior authorization process.

Are Manager Prior Authorization jobs in high demand?

Manager Prior Authorization jobs are in steady demand within healthcare and insurance industries, as they are essential for processing and approving medical requests. These roles often require strong organizational skills, knowledge of healthcare policies, and familiarity with authorization software, making them valuable in organizations focused on efficient patient care and cost management.

Is manager prior authorization a stressful job?

Manager prior authorization roles can be stressful due to the need to review and approve healthcare requests efficiently while managing strict deadlines and compliance standards. The job often involves handling complex cases, coordinating with healthcare providers, and maintaining accuracy under pressure. Stress levels vary depending on workload, organizational support, and experience.

What career paths follow manager prior authorization?

A manager in prior authorization can advance to roles such as senior manager, director of utilization management, or healthcare operations manager. They may also transition into related fields like healthcare compliance, case management, or healthcare administration, often leveraging skills in policy, documentation, and team leadership.

What are the most commonly searched types of Prior Authorization jobs in Kentucky?

The most popular types of Prior Authorization jobs in Kentucky are:

What are popular job titles related to Manager Prior Authorization jobs in Kentucky?

For Manager Prior Authorization jobs in Kentucky, the most frequently searched job titles are:

What job categories do people searching Manager Prior Authorization jobs in Kentucky look for?

The top searched job categories for Manager Prior Authorization jobs in Kentucky are:

What cities in Kentucky are hiring for Manager Prior Authorization jobs?

Cities in Kentucky with the most Manager Prior Authorization job openings:

Manager Prior Authorization jobs near you

Prior Authorization Clinical Pharmacist

Elevance Health

Louisville, KY • On-site

$113K - $136K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Elevance Health rating

7.5

Company rating: 7.5 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

218th of 315 rated insurance

Job description

Prior Authorization Clinical Pharmacist

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Prior Authorization Clinical Pharmacist is responsible for evaluating and managing the selection and utilization of pharmaceuticals to ensure safe, effective, and cost-efficient medication use. This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug Information Services (DIS), and formulary management.

How you will make an impact:

  • Researches and synthesizes detailed clinical data related to pharmaceuticals.

  • Prepares and presents therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.

  • May review and approve or deny coverage for pharmaceuticals (as permitted by state/federal law or state/federal program contracts) based on medical necessity criteria, and coordinates with internal stakeholders or health plan medical directors as needed.

  • Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.

  • Prepares information for network physicians.

  • Prepares and presents therapeutic class reviews and drug monographs to the Pharmacy and Therapeutics (P&T) Committee.

  • Provides clinical guidance for therapeutic interventions, dosage conversions, and evidence-based medication use.

  • Develops and communicates drug information and recommendations to network physicians and clinical teams.

Minimum Requirements:

  • Requires BA/BS in Pharmacy.

  • Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.

  • Requires a registered pharmacist.

  • Current unrestricted Pharmacist license in applicable state(s) required.

  • For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position.

Preferred Skills, Capabilities and Experiences:

  • Active, unrestricted license to practice pharmacy as a Registered Pharmacist (RPh) in the state of Kansas highly preferred.

  • PharmD preferred.

  • PBM experience preferred.

  • Prior Authorization experience preferred.

  • Specialty Medication experience preferred.

Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US, unless they are command-sanctioned activities.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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