- KPH Healthcare Services, Inc. (North Syracuse, NY)
- …For over 50 years, the HealthDirect team has been dedicated to the unique pharmacy needs of individuals residing in Long-Term Care (LTC) facilities such as nursing ... prescription medications, over-the-counter products, clinical consulting services, and specialty pharmacy services to more than 50,000 residents. HealthDirect is a… more
- Option Care Health (Seattle, WA)
- …From $21/hour This position is responsible for processing benefit verification or prior authorization responsibilities of all new referrals within the expected ... quality. **Job Description:** **Job Responsibilities** + Processes benefit verification or authorization for all new referrals with speed and accuracy. + Assist… more
- BrightSpring Health Services (Oklahoma City, OK)
- …and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. Schedule: On site in ... our growing network of branches and healthcare professionals. The Prior Authorizaton Specialist will be responsible for...+ Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply,… more
- Henry Ford Health System (Bingham Farms, MI)
- …place referral for patient follow-up in specialty clinics/departments, and facilitate prior authorization with appropriate pharmacy partners across ... GENERAL SUMMARY: The Pharmacy Specialist provides oversight and leadership...primary care or managed care is strongly desired. . Prior experience and knowledge or integrated health systems .… more
- Baptist Memorial (Memphis, TN)
- Summary Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation therapy/radiology/ surgical services meet ... education + Employee referral program Job Summary: Position: 18063 - Specialist - Authorization Denial Facility: BMHCC Corporate Office Department: HS Denial… more
- Veterans Affairs, Veterans Health Administration (Fredericksburg, VA)
- …Major duties include, but are not limited to: Program management Process all Prior Authorization Drug Request Consults for Fredericksburg HCC providers, and if ... have 1 (one) year of experience equivalent to the next lower grade level. Clinical Pharmacy Specialist . The clinical pharmacy specialist (CPS) functions… more
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- …and professional manner as appropriate. Reviews and evaluates requests for prior authorization and restricted medications for appropriateness and compliance ... subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested...occupation and meet the criteria). Grade Determinations: GS-13, Clinical Pharmacy Specialist Experience. In addition to the… more
- Henry Ford Health System (Troy, MI)
- …Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization , and pharmacy benefit inquiries from ... in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes. PRINCIPLE DUTIES AND RESPONSIBILITIES: +… more
- Ardon (Portland, OR)
- …computer applications. Ability to work in a fast-paced environment. Knowledge of pharmacy benefit investigation, prior authorization support, and patient ... to grow, we are seeking a Billing & Insurance Specialist to join our award-winning specialty pharmacy ...Oregon Pharmacy Technician License. A Certified Oregon Pharmacy Technician License will be required prior … more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Authorization Specialist works with providers, patients, ancillary departments, pharmacy and insurance carriers to ensure that all ... orders and insurance claim submission. Experience with healthcare insurance prior authorization /coding and performing insurance carrier/managed care review… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Medical University Hospital retail pharmacy revenue through provision of prior authorization services at Upstate Medical University Hospital clinics. Minimum ... Job Summary: The primary responsibility of the Pharmacy Patient Access Specialist includes the...ordered from SUNY Upstate clinics and the associated providers prior to enrollment into the specialty pharmacy … more
- MD Anderson Cancer Center (Houston, TX)
- …to comply with institutional standards, initiatives, and guidelines (ABN's, prior authorization requirements, reimbursement optimization, formulary management, ... a one to one basis. **Preferred Experience:** Experience as a clinical pharmacy specialist **Onsite Presence: Is Required** **WORKING CONDITIONS** Frequency… more
- CDPHP (Albany, NY)
- …technical aspects of pharmacy benefits. This individual implements medical exception/ prior authorization decisions made by Pharmacists and/or Managed Care ... you to be a part of that experience. The Pharmacy Benefit Technical Specialist is responsible for...Specialists will be responsible for answering calls from a pharmacy phone queue, advising on pharmacy matters… more
- SSM Health (Madison, WI)
- …service experience through the provision of benefits investigations and conducting prior authorization services. Develops a thorough understanding of payer ... calling** WI-SSM Health West Beltline **Worker Type:** PRN **Job Highlights:** + Department: Pharmacy + Schedule: PRN, Day Shift, Hours will be as needed (fill-in… more
- University of Rochester (Rochester, NY)
- …clinics. Duties will include collaboration with clinical staff to acquire prior authorization for relevant providers, benefit investigation, enrollment of ... able to establish strong collaborative working relationships. **SPECIFIC RESPONSIBILITIES:** **A. Prior Authorization Management** 1. Highly knowledgeable of the… more
- KPH Healthcare Services, Inc. (Flowood, MS)
- …+ Responsible for contacting members and prescribers on non-covered items + Facilitate prior authorization process for customers + Provide clinical services in ... requirements** **.** Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/11219/patient-benefit- specialist -specialty- pharmacy -technician/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations**… more
- Hartford HealthCare (Farmington, CT)
- …30 different specialties. *_ Job Description_* Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to ... providers and other clinical departments, as applicable. . Monitors and reviews the prior authorization work queue daily to verify accuracy of patient's… more
- Intermountain Health (Denver, CO)
- …Resolve shipping problems/errors and expedite backorders. Evaluate and authorize approval of prior authorization pharmacy requests from prescribers received ... office staff, medical management staff and/or pharmacists. Research, resolve and document prior authorization outcomes in pharmacy system. Communicate… more
- Molina Healthcare (Georgetown, KY)
- …those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs ... **Molina Health** care is hiring for a remote ** Pharmacy Operations Specialist ** This role can...and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …throughout the discharge process. Assists with the review of Prior Authorization Drug Requests. Answers questions from pharmacy and non- pharmacy ... Summary The Clinical Pharmacy Technician will perform work with oversight by...with oversight by a clinical pharmacist, a Clinical Pharmacist Specialist (CPS) for the assigned program area, or other… more
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