{"id":3061773,"url":"https://alion.io/job/medimpact-prior-authorization-coordinator-i","title":"Prior Authorization Coordinator I","company":{"id":2093547,"name":"Medimpact","domain":"medimpact.com","url":"https://alion.io/company/medimpact-com","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"B","score":80,"open_postings":5,"ghost_share":0,"stale_share":1,"repost_share":0,"time_to_fill_p50_days":7,"computed_at":"2026-10-30T05:48:23Z"}},"role":"Administrative","role_family":"Administrative","seniority":"junior","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Tempe, United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":38000,"max_usd":65000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":348},"experience_years_min":1,"visa_sponsorship":true,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Office","optional":false},{"name":"Outlook","optional":false},{"name":"Windows","optional":false}],"status":"closed","first_seen_at":"2026-10-21T00:00:00Z","employer_posted_date":"2026-10-21","last_verified_at":"2026-10-28T03:26:35Z","board_verified":false,"closed_at":"2026-10-28T03:26:35Z","days_open":7,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":7},"description":"Exemption Status:\nUnited States of America (Non-Exempt)$17.69 - $22.55 - $27.41“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”\nThis position is not eligible for Sponsorship.\nMedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!\nWhy join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.\nAt MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!\nJob Description\nSummary\nWorks as a member of the Prior Authorization Operations team. Processes prior authorization requests in accordance with standards for accuracy, timeliness, productivity, and client performance commitments. Uses various business applications to perform analysis, obtain information, and enter prior authorization data necessary for claims adjudication. Utilizes reasoning skills to identify missing information and make prior authorization processing determinations based upon clinical protocols and client guidelines (approve, pend, refer for clinical decision, etc.). Interacts with internal and external customers to provide and obtain information and ensures the delivery of outstanding service and quality. Works under general supervision, relying on instructions, work process guidelines, policies & procedures, and company knowledge/experience to perform the functions of the job. Extent of supervision ranges from close, to moderate, to minimal oversight based upon demonstrated skill and performance levels as defined for the position. This position is part of a three level career path with progression opportunities described in the Core Processing Career Path/Succession Planning Guidelines.\nEssential Duties and Responsibilities include the following. Other duties may be assigned.\nProcess and finalize Prior Authorization (PA) requests within clients’ turnaround time and Performance Guarantees utilizing guidelines. Enter PAs into the system and prioritize requests. Check formulary alternatives, review tried and failed medications. Utilize drug references and verify the drug being requested is indicated and approved for the condition. Document all related information regarding the PA approval or non-approval. Respond to requests by faxing status of the PA to the physician or pharmacy\nConforms to defined roles & responsibilities and rules of engagement between prior authorization processing and clinical decision making. Partners with assigned clinical pharmacists to ensure strict adherence to the boundaries and timeframes of administrative processing.\nAccountable to achieve prior authorization processing productivity and accuracy standards.\nAnalyzes, researches, and resolves prior authorization processing issues as appropriate for experience and career path level, including making written or telephone inquiries to obtain information from clients, members, physicians, or pharmacies; obtaining input from team subject matter experts (SME) or supervisor; and referring unique or high dollar requests to supervisor according to guidelines.\nCoordinates notifications to members, physicians, and pharmacies as required to obtain missing information, manage pended requests, and communicate prior authorization determinations. Documents prior authorization related information and status. Makes outbound calls to obtain information and answer questions about prior authorization status\nProcess and finalize Prior Authorization (PA) requests within clients’ turnaround time and Performance Guarantees utilizing guidelines. Enter PAs into the system and prioritize requests. Check formulary alternatives, review tried and failed medications. Utilize drug references and verify the drug being requested is indicated and approved for the condition. Document all related information regarding the PA approval or non-approval. Respond to requests by faxing status of the PA to the physician or pharmacy\nConforms to defined roles & responsibilities and rules of engagement between prior authorization processing and clinical decision making. Partners with assigned clinical pharmacists to ensure strict adherence to the boundaries and timeframes of administrative processing.\nAccountable to achieve prior authorization processing productivity and accuracy standards.\nAnalyzes, researches, and resolves prior authorization processing issues as appropriate for experience and career path level, including making written or telephone inquiries to obtain information from clients, members, physicians, or pharmacies; obtaining input from team subject matter experts (SME) or supervisor; and referring unique or high dollar requests to supervisor according to guidelines.\nCoordinates notifications to members, physicians, and pharmacies as required to obtain missing information, manage pended requests, and communicate prior authorization determinations. Documents prior authorization related information and status. Makes outbound calls to obtain information and answer questions about prior authorization status. \nCollaborates with MCO and Self-Insured client teams to understand PBM clients’ prior authorization processing requirements and expectations. As appropriate for experience and career path level, partners with client teams to complete special prior authorization processing projects and provide accurate, timely, and reliable information to client claim inquiries. (PAC II/II)\nCollaborates with Contact Center Services in resolving prior authorization inquiries\nHandling Provider, Pharmacy and member calls to complete prior authorization and Peer to Peer requests based on client specific requirements\nProtects and maintains confidentiality and privacy of all prior authorization and member information, including following strict protocols for date stamping and storage/security of prior authorization forms and related information.\nNo supervisory responsibilities\nEducation and/or Experience\nGED/HS Diploma and 1+ year experience or equivalent combination of education and experience\nComputer Skills\nIntermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs. Experience with Windows based database programs is also required.\nCertificates, Licenses, Registrations\nMust successfully complete one of the national certification exams OR obtain state licensure (in any U.S. State). Maintains a current Pharmacy Technician License and/or CPhT certification without restriction.\nOther Skills and Abilities\nNone required\nReasoning Ability\nAbility to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.\nAbility to define problems, collect data, establish facts, and draw valid conclusions.\nMathematical Skills\nAbility to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.\nAbility to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.\nLanguage Skills\nAbility to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.\n.\nAbility to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. \nCompetencies To perform the job successfully, an individual should demonstrate the following competencies:\nComposure\nDecision Quality\nOrganizational Agility\nProblem Solving\nCustomer Focus\nDrive for Results\nPeer Relations\nTime Management\nDealing with Ambiguity\nLearning on the Fly\nPolitical Savvy\nPhysical Demands\nThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.\nWhile performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds.\nWork Environment\nThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.\nThe noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).\nWork Location\nThis position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.\nWorking Hours\nThis is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm.\nTravel\nThis position requires no travel however attendance may be required at various local conferences and meetings.\nThe Perks:\nMedical / Dental / Vision / Wellness Programs\n\nPaid Time Off / Company Paid Holidays\n\nIncentive Compensation\n\n401K with Company match\n\nLife and Disability Insurance\n\nTuition Reimbursement\n\nEmployee Referral Bonus\n\nTo explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers\nMedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.\nEqual Opportunity Employer, Male/Female/Disabilities/Veterans\nOSHA/ADA:\nTo perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.\nReasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.\nDisclaimer:\nThe above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.","description_format":"text","description_chars":11889,"description_truncated":false,"requirements":{"experience_years_min":1,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":false},"security_clearance":false,"languages":[]},"benefits":["401k plan","Wellness"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":[],"lifecycle":[{"event":"open","at":"2026-10-22T06:47:06Z"},{"event":"close","at":"2026-10-28T03:26:35Z"}],"visa":[],"liveness":null,"pay":null,"html_url":"https://alion.io/job/medimpact-prior-authorization-coordinator-i","json_url":"https://alion.io/job/medimpact-prior-authorization-coordinator-i.json","meta":{"generated_at":"2026-10-30T09:32:10Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":13700,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-31T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":2093547},"rest":"https://alion.io/mcp/rest/get_company?id=2093547"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fmedimpact-prior-authorization-coordinator-i"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fmedimpact-prior-authorization-coordinator-i"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fmedimpact-prior-authorization-coordinator-i"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/medimpact-prior-authorization-coordinator-i\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fmedimpact-prior-authorization-coordinator-i"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":3061773}},{"tool":"search_jobs","arguments":{"company":"medimpact.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":3061773},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. Docs: https://alion.io/developers"}}