A problem solver with a passion for helping others, Taylor DeRuiter was drawn to the healthcare field during his time at Auburn University, where he studied biomedical sciences. He graduated with a Doctor of Pharmacy and entered the field of pharmacy prior authorizations in 2016. As RxBenefits’ manager of clinical operations, Taylor oversees and manages the prior authorization program and its team of clinical pharmacists, coverage determination technicians, coverage determination analysts, and quality assurance pharmacists.
“What I enjoy most about my role is having an impact,” Taylor says. “I enjoy tackling a problem and finding room for improvement in the day-to-day operations — anything that lets me positively impact our team, our clients, and our members.”
His role requires juggling many responsibilities to help the prior authorization team maintain a quick response time for members. From data entry with multiple sources of information to reviewer coordination across companies to delivering quick decisions while assuring their quality, Taylor and his team must be adaptable and precise.
“When we’re making changes or having to adapt, we have to make sure every piece of the puzzle fits together, because all these things have to be working in the same direction,” Taylor says. “The challenge is always ensuring everyone is on the same page and knows what to do in their specific role in this complex industry. It’s a challenge that grows daily.”
Taylor brings to RxBenefits experience managing prior authorization programs for private sector and Medicaid clients, clinical criteria development, and formulary management. His previous roles taught him different methods and tactics to ensure a program is compliant and meets a client’s expectations.
Though prior authorization review can seem simple, the program operations are nuanced. Taylor’s team finds success by combining their experience, keeping an unbiased mindset, and confidently approaching decisions. “You have to have an interest in investigating and solving problems, be adaptable and willing to change to work in this field,” Taylor says. “You’ve got to have a good rapport with your team and not only have a good relationship but prioritize them as people.”
Taylor works to keep his two-year-old daughter happy when he’s not at the office. “I love spending time with her. She runs this house,” Taylor says. He has four family members who work as pharmacists, and his father teaches at the pharmacy school in Auburn with a focus on drugs and disease — but they don’t talk about pharmacy at the dinner table.
