Prior Authorization Supervisor

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).

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. This is an onsite role based at our Pittsburgh Hub. Applicants must be based in or willing to relocate to the greater Pittsburgh, PA area.

About the Role

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.

This role reports to the Director, Centralized Clinical Services and is critical to delivering exceptional outcomes for our patients and clinic partners.

Key Responsibilities

Prior Authorization Expertise Workflow Ownership

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

Maintain a working caseload to model best practices, demonstrate PA excellence, and stay current on payer policy changes and clinical criteria

Develop, document, and continuously improve standard operating procedures (SOPs) for the full PA lifecycle, ensuring consistency and compliance across the team

Ensure accuracy and timeliness of PA submissions by monitoring payer-specific requirements for specialty drug classes (e.g., oncology, immunology)

Serve as escalation point for complex, denied, or time-sensitive cases—leading appeals strategy and coordinating with prescribers and clinical staff as needed

Stay current on payer landscape changes, formulary updates, and specialty drug coverage policies and proactively translate these into updated workflows

Team Leadership Development

Lead, coach, and develop a team of onsite and remote Care Coordinators working on the Prior Authorization team, fostering a culture of accountability, clinical excellence, and continuous improvement

Conduct regular 1:1s and structured performance reviews to identify development opportunities, address performance gaps, and retain top talent

Manage scheduling, PTO coverage, and workload distribution to ensure consistent service levels and team wellbeing

Collaborate with the training lead to design and deliver PA-specific onboarding and ongoing education—including payer updates, denial trends, and documentation best practices

Execute structured QA audits on PA submissions and outcomes; report metrics and drive corrective actions based on findings

Champion team morale and a collaborative, patient-first culture

Operational Performance Reporting

Track and report on key PA performance metrics including approval rates, turnaround times, denial rates, appeal success rates, and patient impact

Partner with operations leadership to set and achieve productivity benchmarks, ensuring accountability across the team

Identify patterns in denials and payer behavior to proactively address root causes and improve first-pass approval rates

Support clinic launch readiness by ensuring PA workflows are fully established and operational before go-live

Collaborate cross-functionally with care coordinators, pharmacists, and clinical operations to remove barriers in the patient access journey

Provide subject matter expertise to client-facing teams during implementation, QBRs, and operational reviews as needed

About You

You have deep, hands-on experience managing specialty pharmacy prior authorizations—you know the end-to-end PA process inside and out, including appeals, peer-to-peers, and payer-specific nuances

You are a proven leader who earns credibility through expertise, not just title—your team looks to you as a PA resource first, and a manager second

You have managed or mentored a team of PA specialists and understand the balance between coaching others and maintaining your own clinical sharpness

You thrive in a fast-paced, startup-style environment and are energized by building and improving systems from the ground up

You have experience with specialty drug categories such as oncology, immunology, neurology, or rare disease and understand the clinical nuances that drive PA outcomes

You are comfortable navigating pharmacy an…