Manager, Clinical Services - PA Pharmacists

It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. The Manager, Clinical Services PA Pharmacists is a hands-on people leader responsible for the daily operations, clinical oversight, and escalation management for a team of Prior Authorization (PA) Pharmacists. This role maintains an active clinical review workload while serving as the primary point of accountability for team leadership, pharmacist-level escalations, and issue resolution with internal and external stakeholders. The Manager partners closely with Clinical Services leadership and cross-functional teams to ensure timely, accurate, high-quality, and compliant prior authorization determinations, while driving operational performance and clinical consistency. Role And Responsibilities People Management & Team Leadership Directly manages a team of Prior Authorization Pharmacists, providing daily leadership, coaching, and performance management. Conducts regular one-on-ones, team huddles, performance check-ins, and annual evaluations. Oversees attendance, schedule adherence, PTO coordination, and daily staffing coverage to support SLA requirements. Leads performance management activities, including coaching, corrective action, and development planning in partnership with HR. Promotes a culture of accountability, professionalism, and clinical excellence. Clinical Operations Maintains an active prior authorization review workload, performing clinical reviews in accordance with established criteria, policies, and regulatory requirements. Conducts timely and accurate evaluation of medication requests and coverage determinations. Models expected standards for clinical quality, turnaround time, documentation, and decision consistency. Provides real-time clinical guidance and decision support to pharmacists during daily operations. Escalations & Issue Resolution Serves as the primary escalation point for complex, high-risk, or sensitive PA cases. Addresses pharmacist workflow, quality, and performance concerns. Resolves escalated issues from Account Management and other internal partners related to PA decisions or service delivery. Conducts root cause analysis and implements corrective actions and process improvements. Elevates unresolved or high-impact issues to leadership with clear analysis and recommendations. Cross-Functional Collaboration Represents the PA Pharmacist team in cross-functional initiatives across operations, quality, technology, and process improvement. Translates operational and clinical requirements into clear guidance for frontline teams. Communicates policy, process, and system changes effectively to ensure smooth adoption. Supports departmental projects and initiatives aligned to organizational goals. Quality, Compliance & Continuous Improvement Ensures adherence to clinical policies, PA criteria, regulatory requirements, and internal SOPs. Maintains compliance with HIPAA and all applicable state and federal regulations. Monitors quality and performance trends and implements remediation plans as needed. Supports audit readiness and continuous improvement initiatives across the PA function.

Qualifications

And Education Requirements Doctor of Pharmacy (PharmD) required. Active pharmacist license in good standing. 3+ years of prior authorization, PBM, or utilization management experience preferred. Demonstrated experience in people leadership, coaching, and performance management preferred. Strong clinical judgment, communication, and problem-solving skills. Familiarity with healthcare regulations and PBM compliance requirements. Experience with prior authorization platforms and electronic workflows. Proficiency in Microsoft Office Suite and clinical decision-support tools. Strong organizational skills, attention to detail, and ability to thrive in a fast-paced environment. Excellent written and verbal communication skills. Demonstrated ability to work independently and collaboratively as a team leader. Preferences Pharmacy Practice Residency (Clinical). Prior experience in a manager, lead, or escalation-focused role. Experience supporting audits, quality initiatives, or system implementations. Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This is a largely sedentary role; however, some standing, walking, bending, and reaching may be required. Regularly operates in an office or home office setting which involves utilizing a computer, mouse, keyboard, and occasionally operates other standard office equipment, such as printer, copier, phone. Travel may be required by either car or airplane, or a combination of multiple modes of transportation. What We Do LucyRx is an independent, next-generation pharmacy benefits manager (PBM) transforming how healthcare works. We’re fixing what’s broken in the PBM industry by putting people first and challenging outdated norms. For too long, traditional PBMs have prioritized profit over patients, and we believe that’s just plain wrong. LucyRx offers bold, innovative solutions powered by LucyIQ, our proprietary AI platform, to deliver actionable insights that lower costs, improve care, and simplify prescription management. While we’re new to the PBM space, LucyRx is built on decades of leadership experience and a commitment to meaningful change. We’re a nimble, remote-first team with a bold mission to redefine pharmacy benefits—and we’re just getting started. What It’s Like to Work at LucyRx At LucyRx, we’re a fast-moving team dedicated to making healthcare simpler, fairer, and more effective. Joining us means being part of a dynamic, mission-driven group that works collaboratively to challenge outdated industry practices and redefine what’s possible in pharmacy benefits. We value accountability, innovation, and a relentless focus on making an impact. Here, you’ll find a supportive culture that encourages you to bring your whole self to work, share bold ideas, and grow alongside smart, driven colleagues who are passionate about fixing the PBM industry. If you’re ready to roll up your sleeves and make a real difference, we’d love to have you on our team. Salary: $140,747 - $164,938 Apply To This Job