Summary The VISN 21 Prior Authorization Drug Request (PADR) Program is a centralized clinical service that ensures safe, appropriate, and cost-effective medication use for Veterans across the Sierra Pacific Network. VISN 21 serves Veterans in Northern and Central California, Nevada, Hawaii, the Philippines, and U.S. Territories in the Pacific Basin. Responsibilities Under the direction of the VISN 21 Pharmacy Executive, the VISN Pharmacy Benefits Management (PBM), Prior Authorization (PA) Coordinator/Program Manager is responsible for leading the VISN-level PADR program and team. Duties: Leadership, Oversight, and Personnel Management Provide operational leadership and direction for the VISN-level PADR program, ensuring consistent, timely adjudication of all medication requests. Develop and maintain VISN-wide SOPs, criteria for use, and standardized review processes in alignment with national PBM standards and regulatory requirements. Serve as the primary liaison with VISN committees, facility leadership, and pharmacy stakeholders. Oversee staffing, workload alignment, and performance management for PADR pharmacists and technicians. Lead recruitment, onboarding, training, and professional development of PADR personnel, coordinating with Human Resources on necessary personnel actions. Supports the team by adjudicating PADRs and providing program and staff leadership, while exercising initiative and collaborating effectively with all stakeholders to promote safe, evidence-based care for Veterans. Quality Assurance, Education, and Strategic Planning Develop annual business and operational plans aligned with VISN leadership priorities, monitoring program costs and resource needs to ensure efficient operations. Support PBM formulary and utilization initiatives to promote safe, cost-effective medication use. Provide education and training on PADR processes, formulary guidance, and standardized competencies for PADR staff. Lead quality assurance efforts to ensure consistency, regulatory readiness, and adherence to national standards across all participating facilities. Strengthen consistency and transparency in adjudication processes, while contributing subject matter expertise to enhance program impact. Track key metrics and share data with leadership to inform decision-making and program improvement. Work Schedule: Monday-Friday, 7:30am - 4:00pm PST (Subject to Change to meet organization needs) Telework: Ad-hoc per policy. Virtual: This is not a virtual position. Functional Statement #: 09263-F Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Must be proficient in written and spoken English. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Complete all application requirements detailed in the "Required Documents" section of this announcement. Qualifications Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education: Graduate of an Accreditation Council for Pharmacy Education (ACPE) accredited College or School of Pharmacy with a baccalaureate degree in pharmacy (BS Pharmacy) and/or a Doctor of Pharmacy (Pharm.D.) degree. Verification of approved degree programs may be obtained from the Accreditation Council for Pharmacy Education, 20 North Clark Street, Suite 2500, Chicago, Illinois 60602-5109; phone: (312) 664-3575, or through their Web site at: http://www.acpe-accredit.org/. (NOTE: Prior to 2005 ACPE accredited both baccalaureate and Doctor of Pharmacy terminal degree program. Today the sole degree is Doctor of Pharmacy.). Graduates of foreign pharmacy degree programs meet the educational requirement if the 2 graduate is able to provide proof of achieving the Foreign Pharmacy Graduate Examination Commission (FPGEC) Certification, which includes passing the Foreign Pharmacy Graduate Equivalency Examination). Licensure: Full, current and unrestricted license to practice pharmacy in a State, Territory, Commonwealth of the United States (i.e., Puerto Rico), or the District of Columbia. The pharmacist must maintain current registration if this is a requirement for maintaining full, current, and unrestricted licensure. A pharmacist who has, or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions in VA Handbook 5005, Part II, Chapter 3, section B, paragraph 16. Demonstrated KSAs. Skill in persuading others and gaining cooperation to accomplish goals. Ability to effectively communicate orally and in writing regarding complex clinical and technical issues. Skill in utilizing regulatory and quality standards to develop and implement operational programs. Skill in managing multiple people or programs. 5. Skill in utilizing available resources to support the mission and goals of the organization. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: In addition to the GS-13 requirements, must have 1 year of experience equivalent to the next lower grade level. Preferred Experience: Minimum of three years of experience in pharmacoeconomics and formulary management. Prior experience managing Prior Authorization Drug Request (PADR) programs. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-14. Physical Requirements: Work is generally sedentary, but requires standing, walking, bending, stooping and reaching for objects when conducting Health Care System on-site evaluations For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/. Education Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information Receiving Service Credit for Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
