Clinical Team Lead

2 weeks ago

Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

Job Summary:

Access Healthcare Services Manila, Inc. is seeking a highly skilled Team Leader to oversee operations for our Pharmacy Utilization account based in Taguig City.

The ideal candidate must be a Licensed Pharmacist with extensive experience managing U.S. healthcare accounts, particularly in pharmacy utilization management, prior authorization, and compliance.

This role requires strong leadership, process expertise, and the ability to drive performance while ensuring compliance with healthcare regulations.

Responsibilities:

  • Lead and manage a team handling pharmacy utilization review, prior authorizations, and medication coverage determinations.
  • Develop and implement process improvements to drive efficiency and quality.
  • Maintain relationships with clients, stakeholders, and internal teams to optimize processes and improve operational efficiency.
  • Ensure compliance with HIPAA, CMS, and other regulatory requirements.
  • Collaborate with cross-functional teams to achieve business objectives.

Requirements:

  • Bachelor's degree in Pharmacy or related field.
  • At least 5 years of experience in pharmacy utilization management, prior authorization, and compliance.
  • Proven track record of leading high-performing teams and driving business results.
  • Strong knowledge of pharmacy benefit management (PBM), claims processing, and medication guidelines.
  • Excellent communication, problem-solving, and leadership skills.

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