- US Tech Solutions (RI)
- **Job Title: Prior Authorization Specialist** **Location: Fully remote ** **Duration: 12 months contract** **Job Description:** + Prior Authorization ... phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely...center environment managing 75 calls/day. + Six months of PBM /pharmaceutical related work strongly desired + At least two… more
- Actalent (Nashville, TN)
- …Microsoft Office and Outlook. + Basic computer skills. + Experience with prior authorization processes. Additional Skills & Qualifications + Customer service ... and notify providers and/or members. + Respond to client inquiries regarding authorization approvals and PBM online applications. + Refer coverage determination… more
- Molina Healthcare (Georgetown, KY)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... **Molina Health** care is hiring for a remote **Pharmacy Operations Specialist** This role can be...+ Performs initial receipt and review of non-formulary or prior authorization requests against plan approved criteria.… more
- US Tech Solutions (May, OK)
- **Job Title: Prior Authorization Pharmacist- Remote ** **Location: Fully remote ** **Duration: 6 months contract** **Note: Ideal candidates must have ... experience of Prior Authorization , Medicare Part D and Pharmacy...as per policy and procedure. **Skills:** Prior Authorization Medicare Part D Pharmacy Benefit Management ( PBM… more
- Actalent (Dallas, TX)
- …+ 2+ Years of Experience of working as Pharmacy Technician is Mandatory ( prior Authorization Experience) + Should Hold Active PTCB and state License ... Immediate Hiring for Remote Certified Pharmacy Technician Job Description: * Obtain...providers and/or members * Respond to client inquiries regarding authorization approvals and PBM on-line applications Qualifications:… more
- US Tech Solutions (May, OK)
- …**Job Description:** + Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This ... be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure....Medicare Part D + Must Have Pharmacy Benefit Management ( PBM ) experience. **Education:** + Pharm D. required with at… more
- Actalent (Greenville, SC)
- …by the state of operation. + Basic computer skills. + Experience with prior authorization and prescription benefits. + Proficiency in Microsoft Office, including ... Remote Certified Pharmacy Technician Job Description We are...join our team. In this role, you will review Prior Authorizations, make determinations, and forward them to a… more
- CVS Health (Sacramento, CA)
- …Clients as assigned. The Medical Director transacts Utilization Management UM activities ( prior authorization and appeals) and responds to prescriber inquiries ... Clients as assigned. The Medical Director transacts Utilization Management UM activities ( prior authorization and appeals) and responds to prescriber inquiries… more
- Access Dubuque (Dubuque, IA)
- …expectations and support retention. + Manage the clinical review and prior authorization processes, explaining clinical rationale, formulary alternatives, and ... **About MedOne:** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully...or Kansas City, MO, or the position can be remote within the United States. **Employment Type:** Full-Time, Salaried… more
- US Tech Solutions (May, OK)
- …experience working in PBM on managed care environments + **Skills:** + Prior Authorization + Medicare and Medicaid + Call handling experience. + ... Tech I is the initial point of contact for Prior Authorization requests from members, providers, and...GED is required. **Job Title: Pharmacy Tech** **Location: Fully remote ** **Duration: 12 months contract** **Job Description:** + The… more
- The Cigna Group (Bloomfield, CT)
- …Chronic Condition support + Physician referrals + Referral to Case Management for authorization assistance + Retail/mail order and benefit questions + Assist on any ... experience; 2 or more years in managed care, the PBM industry, or pharmaceutical sales preferred + Ability to...same time, with multiple tabs/programs open This role is remote but Pharmacy Care Coordinator must reside in California.… more
- AdventHealth (Apopka, FL)
- …productivity standards. This position oversees the prescription intake, claims adjudication, prior authorization , and technician quality assurance processes to ... staff and physician office(s) on any questions regarding formulary coverages, eligibility, prior authorization , or general plan guidelines. + Maintains an… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- …outcome assessments, and cost containment activities. Manages the non-formulary and prior authorization drug approval process including the establishment and ... strategic plan by fully utilizing the VISN and National PBM pharmacoeconomic resources and community by translating national data,...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- …compliance with established drug therapy policies, formulary management and criteria or prior authorization requirements that have been approved by national, ... VISN, or local pharmacy benefits management ( PBM ) and focuses on quality patient care in a...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more
- Mount Sinai Health System (New York, NY)
- …and working with clinical staff to complete necessary third party (insurance) prior authorization requests (when applicable). They are primarily responsible for ... by triaging pharmacy benefit questions. **Qualifications** While the position is mostly remote , however, it is classified as hybrid. Candidates will need to live… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …Plan's formulary, formulary structure and different benefit stages + Enter and maintain accurate prior authorization records + Answer provider calls as this is a ... GREAT PAY AND BENEFITS! AMAZING WORK LOCATION! NOT A REMOTE POSITION. Position Purpose: As a Certified Pharmacy Technician...between the Pharmacy department and the Pharmacy Benefit Manager ( PBM ) + Work as a Liaison between the Pharmacy… more