ZipRecruiter

Log In

2

Remote Prior Authorization Supervisor Jobs in Virginia

asrcfh

Supervisor Procurement

Reston, VA · On-site +1

Fully remote will be considered for the right candidate. Standard work hours: Due to the varied ... authorization, specifications, delivery requirements, and compliance with contract and FAR ...

asrcfh

Supervisor Procurement

Reston, VA · On-site +1

Fully remote will be considered for the right candidate. Standard work hours: Due to the varied ... authorization, specifications, delivery requirements, and compliance with contract and FAR ...

ICF

Salesforce PSS Developer DHS (Remote)

Reston, VA · Remote

$57.75 - $76.50/hr

Remote work is authorized. Must supportUS Eastern time zoneworking hours. What You Will Do ... Prior experienceperformingDevOpsactivitiesincluding package creation & deployment,code scan ...

next page

Showing results 1-20

All JobsPrior Authorization Supervisor JobsRemote Prior Authorization Supervisor JobsRemote Prior Authorization Supervisor Jobs in Virginia

Remote Prior Authorization Supervisor information

What does a Remote Prior Authorization Supervisor do?

A Remote Prior Authorization Supervisor oversees the team responsible for reviewing and processing prior authorization requests for medical procedures, medications, or treatments, all while working remotely. They ensure compliance with healthcare regulations, monitor staff performance, and streamline workflows to facilitate timely authorizations. Their role also involves training staff, resolving complex cases, and acting as a liaison between providers, payers, and patients to ensure authorization requirements are met efficiently.

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

A Remote Prior Authorization Supervisor often encounters challenges such as coordinating a dispersed team, maintaining consistent communication, and ensuring adherence to compliance standards across various regions. To address these, supervisors can implement regular virtual meetings, utilize collaborative workflow platforms, and provide ongoing training to keep the team updated on policy changes. Establishing clear protocols for documentation and escalation also helps maintain efficiency and quality in the prior authorization process.

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

To thrive as a Remote Prior Authorization Supervisor, you need a solid background in healthcare administration, insurance processes, and prior authorization procedures, often supported by a degree in health sciences or related fields and relevant experience. Familiarity with healthcare management software, electronic medical records (EMRs), and payer authorization portals is usually required, along with certification such as Certified Prior Authorization Specialist (CPAS) being a plus. Strong leadership, problem-solving abilities, and effective communication are crucial soft skills for managing remote teams and resolving authorization challenges. These skills and qualities ensure timely, accurate authorizations, team productivity, and compliance with regulatory standards in a virtual work environment.

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

AspectRemote Prior Authorization SupervisorRemote Prior Authorization Coordinator
CredentialsTypically requires relevant healthcare certifications, experience in insurance or healthcare administrationUsually requires similar certifications, often with less managerial experience
Work EnvironmentSupervises teams, manages workflows, and ensures compliance in healthcare or insurance settingsHandles authorization requests, reviews documentation, and communicates with providers and patients
Employer & Industry UsageCommonly employed by health insurance companies, healthcare providers, and third-party administratorsFound in similar settings, focusing on processing and coordinating prior authorizations

The main difference between a Remote Prior Authorization Supervisor and a Coordinator lies in their responsibilities. Supervisors oversee teams and workflows, while Coordinators focus on processing authorization requests. Both roles require healthcare knowledge and certifications, but supervisors typically have more leadership duties.

What are popular job titles related to Remote Prior Authorization Supervisor jobs in Virginia? For Remote Prior Authorization Supervisor jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization Supervisor jobs in Virginia look for? The top searched job categories for Remote Prior Authorization Supervisor jobs in Virginia are:
What cities in Virginia are hiring for Remote Prior Authorization Supervisor jobs? Cities in Virginia with the most Remote Prior Authorization Supervisor job openings:
Remote Prior Authorization Supervisor jobs near you
Infographic showing various Remote Prior Authorization Supervisor job openings in Virginia as of July 2026, with employment types broken down into 84% Full Time, and 16% Part Time. Highlights an 15% In-person, and 85% Remote job distribution.
Pharmacy Prior Authorization Coordinator I

Pharmacy Prior Authorization Coordinator I

Sentara Healthcare

Virginia Beach, VA • On-site, Remote

$17.75 - $23.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 393 frontline employees who took The Breakroom Quiz

494th of 890 rated healthcare providers

Job description

City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans is looking to hire Pharmacy Prior Authorization Coordinator 1:
This is a remote position: Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming
Shift: Monday- Friday from 8:00am to 8:00pm and must be flexible to work on weekends.
The Pharmacy Prior Authorization Coordinator I is responsible for delivering high-quality customer service by answering and managing calls from members, provider offices, and pharmacies. This role supports the processing of prior authorization (PA) requests for pharmacy benefit medications, ensuring accuracy, compliance with regulatory and clinical guidelines, and alignment with client performance standards. The Coordinator I works under general supervision, using established protocols and systems to support timely, efficient, and accurate PA determinations.
This role uses various business systems and tools to retrieve information, analyze requests, and enter prior authorization data required for claims adjudication. The Coordinator I applies reasoning skills to identify incomplete information and determine appropriate actions based on client-specific criteria and clinical protocols (e.g., approve, pend, refer for clinical decision). The position interacts regularly with internal teams and external stakeholders to ensure consistent, high-quality service delivery. Work is performed under general supervision, with reliance on documented procedures, training, and prior experience to guide day-to-day activities.
Key Responsibilities
  • Verify member insurance eligibility and pharmacy benefit coverage.

  • Communicate with members and providers regarding basic pharmacy inquiries and PA status.

  • Accurately enter and process prior authorization (PA) requests into the system, prioritizing appropriately.

  • Ensure PA requests are processed and finalized within required turnaround times (TAT) and client Performance Guarantees (PGs), using provided clinical guidelines.

  • Review medication history and assess for formulary alternatives and "tried and failed" drugs.

  • Document all relevant PA information clearly and accurately, including approval or denial rationale.

  • Send PA status updates to providers and pharmacies via fax or other required methods.

  • Adhere to defined roles and responsibilities related to clinical decision-making boundaries.

  • Meet or exceed productivity and accuracy targets for PA processing.

  • Coordinate with members, providers, and pharmacies to obtain missing information or clarification.

  • Make outbound calls to gather additional information or respond to inquiries related to PAs, clinical programs, or claim adjudication.

  • Collaborate with Pharmacy Concierge teams to resolve questions or issues related to PA processing or pharmacy benefits.

  • Maintain strict confidentiality and security of all member and PA-related data, following applicable protocols for data handling and storage.

  • In addition to the above responsibilities, other duties may be assigned.

Education
  • High School Diploma or GED strongly preferred.

Experience
  • 1 year healthcare experience required.

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: 19.04/HR - 31.73/HR. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

What Sentara Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply