(Remote – U.S. Based*)
🧾 About the Role
Navitus is redefining what a pharmacy benefit manager should be—transparent, people-first, and committed to affordability. As a Prior Authorization Specialist, you’ll review and process medication requests across multiple healthcare programs, ensuring compliance with regulatory and client-specific guidelines. You’ll work with providers and clinical teams to help patients access the medications they need, while building expertise in pharmacy operations and insurance systems.
✅ Position Highlights
• $16.13–$18.97/hour
• Full-time, remote (with some state restrictions*)
• Health, dental, vision, and 401(k) with 5% match
• 20 PTO days + 9 paid holidays
• 4 weeks paid parental leave
• Flexible Spending Account, Adoption Assistance
• Educational and professional development support
• Referral Bonus Program (up to $750)
📋 What You’ll Own
• Review, process, and troubleshoot incoming prior authorization (PA) requests via phone, fax, and web
• Apply clinical criteria and benefit guidelines to PA decisions
• Act as a provider help desk specialist: assisting with submissions, status updates, and formulary questions
• Maintain up-to-date knowledge of Medicare D, Medicaid, and Exchange programs
• Collaborate with internal teams on PA accuracy, metrics, and compliance
• Ensure HIPAA compliance and protect patient information
• Use downtime to develop skills through internal learning and training platforms
• Contribute to ad hoc projects and team initiatives as assigned
🎯 Must-Have Traits
• High school diploma or GED required; post-secondary medical education or certifications (e.g., LPN, CPhT) preferred
• Previous customer service experience is required
• Prior authorization, PBM, or call center experience strongly preferred
• Familiarity with medical terminology and health/pharmacy insurance processes
• Basic computer literacy and comfort with data entry
• Organized, adaptable, and dependable team player
• Commitment to confidentiality, compliance, and professional development
💻 Remote Requirements
• Must reside in the U.S.
• Navitus does not hire remote workers in: AK, HI, ME, MS, NH, NM, ND, RI, SC, SD, WV, or WY
• Must have a distraction-free environment with reliable internet access
• Regular, predictable attendance is essential
💡 Why It’s a Win for Remote Job Seekers
• Entry point into a growing healthcare company with opportunities for advancement
• Competitive pay and best-in-class benefits
• Paid learning opportunities and industry certifications
• Strong values around people-first culture and patient access
• Work from home with scheduling flexibility
✍️ Call to Action
If you’re detail-oriented, curious, and driven to support patients in accessing essential medications, this is your opportunity to join a mission-driven healthcare organization. Apply now and help shape the future of pharmacy care with Navitus.