Prior Authorization Supervisor

<p>House Rx is on a mission to make specialty medications more affordable and accessible for patients suffering from chronic illnesses like cancer and autoimmune disorders. We provide clinics with specialized technology and support from pharmacists and care coordinators to dispense medication directly to their patients, known as medically integrated dispensing (MID).</p> <p>This role sits at the intersection of clinical expertise and operational leadership—if you are a prior authorization expert who leads by doing and developing others, keep reading to learn more about why House Rx is the right next step in your career. <strong>The</strong> <strong>ideal person would work on-site at our Pittsburgh Hub, be we will consider remote candidates for the right fit. </strong></p> <p><span style="font-size: 12pt;"><strong>About the Role</strong></span></p> <p>We are seeking an experienced Prior Authorization (PA) Supervisor to lead our onsite PA team at our Pittsburgh Hub. This is not a traditional people manager role—we are looking for a working supervisor who is a recognized subject matter expert in end to end specialty pharmacy prior authorization, from payer strategy and clinical criteria to appeal resolution. You will set the standard for the team by doing the work alongside them, while also building the systems, processes, and talent needed to scale a high-performing PA function.</p> <p>This role reports to the Director, Centralized Clinical Services and is critical to delivering exceptional outcomes for our patients and clinic partners.</p> <h1><span style="font-size: 12pt;"><strong>Key Responsibilities</strong></span></h1> <h2><span style="font-size: 10pt;"><strong>Prior Authorization Expertise &amp; Workflow Ownership</strong></span></h2> <ul> <li>Serve as the team’s primary SME for specialty PA workflows; including initial submissions, peer-to-peer coordination, appeals, and exception requests across commercial, Medicare, and Medicaid payers</li> <li>Maintain a working caseload to model best practices, demonstrate PA excellence, and stay current on payer policy changes and clinical criteria</li> <li>Develop, document, and continuously improve standard operating procedures (SOPs) for the full PA lifecycle, ensuring consistency and compliance across the team</li> <li>Ensure accuracy and timeliness of PA submissions by monitoring payer-specific requirements for specialty drug classes (e.g., oncology, immunology)</li> <li>Serve as escalation point for complex, denied, or time-sensitive cases—leading appeals strategy and coordinating with prescribers and clinical staff as needed</li> <li>Stay current on payer landscape changes, formulary updates, and specialty drug cove