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Director, Pharmacy Coverage Reviews at BlueCross BlueShield of Tennessee - ApplyBlast

Director, Pharmacy Coverage Reviews

BlueCross BlueShield of Tennessee

2 months ago

3.7 on Glassdoor

Remote

Full Time

Manager

0 applicants

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About this role

The role oversees day‑to‑day operations for prior authorization and appeals programs, ensuring compliance with regulatory standards and driving process improvements. It involves leading and mentoring staff, analyzing utilization trends, and collaborating with cross‑functional teams to align coverage review operations with enterprise goals.

Responsibilities

Direct day-to-day operations for prior authorization and appeals programs
Lead and mentor managers and staff to improve service quality and turnaround times
Monitor utilization trends and appeal outcomes to identify improvement opportunities

Skills

Qualifications

Doctor of Pharmacy (PharmD)Pharmacy License in Tennessee

About BlueCross BlueShield of Tennessee

bcbst.com

Headquarters

Chattanooga, Tennessee, United States

Company Size

5001-10000 employees

Founded

1945

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Learn more about BlueCross BlueShield of Tennessee (BCBST) health insurance and the medical, dental and vision plans we offer for employers, individuals and families.