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Optum Prior Authorization Supervisor information

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$30.5K

$80K

$112.5K

How much do optum prior authorization supervisor jobs pay per year?

As of Jun 13, 2026, the average yearly pay for optum prior authorization supervisor in the United States is $80,005.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,000.00 and $102,500.00 per year, depending on experience, location, and employer.

What are some common challenges faced by an Optum Prior Authorization Supervisor, and how can they be addressed?

One of the main challenges for an Optum Prior Authorization Supervisor is balancing high-volume case management with ensuring quality and compliance in decision-making. Supervisors often need to support their teams in handling complex cases, navigating changing insurance policies, and meeting tight turnaround times. Effective communication, ongoing training, and fostering a collaborative team environment are key strategies to overcome these challenges. Additionally, leveraging technology and regular feedback sessions can help streamline processes and maintain high standards.

What does an Optum Prior Authorization Supervisor do?

An Optum Prior Authorization Supervisor oversees the team responsible for managing prior authorization requests for medical procedures, medications, and services. They ensure that all requests are processed efficiently, accurately, and in compliance with company policies and healthcare regulations. This role involves supervising staff, monitoring workflow, training team members, and serving as a point of escalation for complex cases. The supervisor also collaborates with healthcare providers, insurance representatives, and internal departments to resolve issues and improve processes.

What is the difference between Optum Prior Authorization Supervisor vs Optum Prior Authorization Coordinator?

AspectOptum Prior Authorization SupervisorOptum Prior Authorization Coordinator
CredentialsTypically requires relevant healthcare or insurance certifications, leadership experienceUsually requires healthcare or insurance-related certifications, entry to mid-level experience
Work EnvironmentSupervises teams, manages workflows, oversees authorization processesPerforms authorization reviews, processes requests, supports team tasks
Employer & Industry UsageUsed in healthcare insurance companies, managed care organizationsCommon in healthcare insurance, provider networks, and managed care settings

The Optum Prior Authorization Supervisor oversees authorization teams and manages workflows, requiring leadership skills and certifications. The Optum Prior Authorization Coordinator handles authorization requests directly, focusing on processing and supporting team operations. Both roles are integral in healthcare insurance environments but differ mainly in responsibility level and scope.

What are the key skills and qualifications needed to thrive as an Optum Prior Authorization Supervisor, and why are they important?

To thrive as an Optum Prior Authorization Supervisor, you generally need extensive knowledge of healthcare processes, prior authorization protocols, and supervisory experience, often supported by a healthcare-related degree or equivalent work experience. Familiarity with medical management software, claims processing systems, and regulatory compliance tools is typically required. Outstanding communication, leadership, and problem-solving abilities help you manage teams and facilitate collaboration with providers and payers. These skills ensure efficient workflow, regulatory compliance, and high-quality service to both patients and healthcare partners.
Infographic showing various Optum Prior Authorization Supervisor job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 86% In-person, 7% Hybrid, and 7% Remote job distribution, with an average salary of $80,005 per year, or $38.5 per hour.
Senior Prior Authorization Specialist

Senior Prior Authorization Specialist

CareMed Specialty Pharmacy

Houston, TX • On-site, Remote

$23 - $25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

Senior Pharmacy Prior Authorization Specialist – CareMed Specialty Pharmacy
Houston, TX | Full-Time | Starting at $25.00/hr and up
Sign-On Bonus: $5,000 for employees starting before July 31, 2026.
CareMed Specialty Pharmacy is seeking a Senior Pharmacy Prior Authorization Specialist to join our dedicated team in Louisville, KY. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.
Company Benefits
  • Medical; Dental; Vision
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Quarterly Incentive Bonus
  • Paid Volunteer Day
  • Referral Incentive Program
  • Company Paid Life Insurance; and Short/Long-Term Disability
Why Join Us?
  • A career with purpose: Help patients access life-saving medications.
  • Supportive culture: We value teamwork, respect, integrity, and passion.
  • Growth opportunities: We invest in your professional and personal development.
What You’ll Do
The Senior Pharmacy Prior Authorization Specialist will work closely with the Prior Authorization Manager and supervisor to ensure completion of challenging cases and escalations in their designated vertical. They will initiate prior authorizations, complete prior authorization forms via webtools such as CoverMyMeds or insurance specific forms including clinical information from clinical notes provided by prescribers, adjudicate test or live claims to review
rejections, and follow up on PA requests with insurance companies, while taking prescriber preferences into account.
Senior Prior Authorization Specialists may also assist with training employees, and other duties as assigned.
How You’ll Do This
  • Works and resolve difficult or escalated cases to assist in processing prescription orders
  • Participates in the orientation and training of prior authorization specialists within workflow vertical.
  • Escalates workflow/process improvement ideas to leadership
  • Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests
  • Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.
  • Runs test claims or live claims to check for payable claims or for valid insurance rejections on medications that require prior authorizations and initiate Prior Authorization requests, using appropriate insurance forms, portals or CoverMyMeds. Reviews accuracy and completeness of information and ensure supporting clinical documentation is included if required.
  • Contacts insurance companies and providers to follow up on prior authorization requests, including
    determining if any additional information is needed, or whether the claim is in review, approved, or denied.
  • Document all prior authorization information in patient profile.
  • Facilitates process for requesting and follow up of prior authorizations with prescribers through preferred contact methods noted in prescriber/patient profiles.
  • Provides guidance to providers and patients in connection with documentation required for payer coverage, support with appeals for denied claims, and follow up with payer to determine outcome.
    Senior Prior Authorization Specialist
  • Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws.
  • Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
  • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
What You Bring
Required:
  • High School Diploma or GED. Previous Experience in Experience in Pharmacy and Prior Authorizations
  • 2+ years pharmacy or prior authorization experience
  • Registration with Board of Pharmacy (as required by state law)
  • Prior authorization process, CoverMyMeds experience, knowledge/understanding of pharmacy
    insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim
    rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related
    knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic
    names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.
Preferred:
  • Associates or Bachelor’s Degree
  • Certified Pharmacy Technician (PTCB), Advanced Certified Pharmacy Technician
  • 3+ years of experience in pharmacy or prior authorizations
  • Specialty pharmacy experience
Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.
Company Values: Teamwork, Respect, Integrity, Passion

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