Remote Prior Authorization Analyst Jobs Near Me

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The Senior Account Operations Manager - PA Network plays a key role in managing complex customer relationships for CoverMyMeds solutions that support pharmacy clients and prior authorization services. This role serves as a primary operational contact for a portfolio of pharmacy customers, including national and regional pharmacy chains and pharmacy management system/software vendor platforms.

In this role, you will help ensure customers receive value from the services they have contracted for, maintain strong day-to-day operational execution, and support healthy program performance. The ideal candidate brings strong client-facing account management experience, sound judgment, data fluency, and the ability to manage escalations and customer conversations with professionalism and confidence.

This position partners closely with cross-functional teams across CoverMyMeds and McKesson to resolve issues, monitor program performance, support contracted deliverables, and advocate for customer needs while balancing operational execution and business objectives.

What You'll Do:

• Serve as the primary point of contact for day-to-day operational management of a portfolio of complex customer accounts and programs

• Manage a book of business that may include approximately 15 to 25 customer accounts, balancing urgency, customer needs, program performance, and business impact

• Partner with pharmacy clients, including retail, national, and regional chains, as well as pharmacy management system or software vendor platforms, in support of prior authorization services

• Support customers using CoverMyMeds prior authorization solutions and services connected through the Relay Health switch

• Own execution of contractual deliverables, helping ensure programs are running according to contract terms, billing expectations, timelines, and customer requirements

• Act as a point of escalation for customer program concerns by investigating issues, coordinating with internal partners, and communicating outcomes clearly and professionally

• Use data, reports, and program performance insights to identify trends, surface opportunities, and help tell a clear story to customers and internal stakeholders

• Lead or participate in customer meetings, business reviews, and performance discussions focused on outcomes, program health, and future opportunities

• Maintain account plans and customer information using Salesforce and other internal tools, ensuring account details, program activity, and follow-up items remain current and organized

• Collaborate cross-functionally with internal teams such as implementation, client support, sales, product, analytics, technology, and other business partners to resolve issues and improve the customer experience

• Promote continuous improvement by identifying process enhancements, operational risks, and opportunities to improve service delivery for customer

Basic Requirements:

• Bachelor's degree in a related field or an equivalent combination of education and relevant experience, and typically requires 4+ years of experience in account operations, account management, customer success, sales, or a closely related client-facing role

• Experience managing customer relationships in a fast-paced environment where responsiveness, follow-through, prioritization, and sound judgment are critical

• Ability to communicate effectively with both technical and non-technical audiences, translating program information, data, and operational details into clear business terms

• Strong organizational skills with the ability to manage multiple accounts, deliverables, escalations, and follow-up items without losing sight of customer commitments

Preferred Skills/Experience:

• Experience managing complex or high-value customer relationships, strategic accounts, or large books of business

• Background in healthcare, health technology, pharmacy, pharmacy benefits management, claims adjudication, reimbursement, prior authorization, or related pharmacy market environments

• Familiarity with pharmacy clients, pharmacy management systems, pharmacy network operations, or services delivered through pharmacy technology platform

• Knowledge of NCPDP standards is a plus, particularly as they relate to claims adjudication and pharmacy transaction formatting

• Experience analyzing data, identifying trends, and translating insights into customer-friendly narratives or business recommendations

• Experience conducting or supporting business reviews, quarterly business reviews, program performance conversations, or executive-level customer discussions

• Experience using CRM platforms such as Salesforce, as well as reporting or analytics tools such as Tableau, Excel, PowerPoint, or proprietary business applications

• Ability to influence without authority and partner effectively across product, analytics, technology, sales, implementation, support, and other internal teams

• Ability to handle escalations, difficult customer conversations, operational issues, and program concerns with composure, professionalism, and a consultative mindset

• Pharmacy or pharmacy technician experience is a plus, but not required

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, pleaseclick here.

Our Base Pay Range for this position

McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind:
McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application.

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McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

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