- Kepro (AL)
- …being a vital partner for health solutions in the public sector. Acentra seeks a Prior Authorization Reviewer to join our growing team. Job Summary: The Prior ... Authorization Reviewer: + Reviews verbal and electronic prior authorization requests based upon pre-established criteria...to 4:00 PM Central. ** ** This is a Remote position within the state of Alabama, where the… more
- CVS Health (Austin, TX)
- …and other Windows based computer applications.* Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical ... Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU)...employee discount at all CVS stores. This is a remote role open to candidates within the United States.… more
- CVS Health (Austin, TX)
- …and other Windows based computer applications.* Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical ... Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU)...employee discount at all CVS stores. This is a remote role open to candidates within the United States.… more
- Hudson Headwaters Health Network (Queensbury, NY)
- …Schedule: 40 hours per week. Monday - Friday 8am-5pm. Note: This is a remote position but must live within driving distance of Queensbury, NY. Position Summary The ... Authorization Specialist ensures that authorization for various...basic administrative/clerical support. Essential Duties and Responsibilities: + Complete Prior Authorizations which include, but are not limited to… more
- Prime Therapeutics (Columbus, OH)
- … Remote Louisiana **Job Description Summary** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by ... office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates… more
- Actalent (Remote, OR)
- …our team. The ideal candidate has to reside in Hawaii. They will support pharmacy operations, assist with prior authorization processes, and collaborate with ... Pharmacy Technician Remote (Must Reside in...a PBM or managed care setting. Strong understanding of pharmacy benefit management processes, prior authorization… more
- Marshfield Clinic (Marshfield, WI)
- …Specific Responsibilities: + Interpret clinical guideline criteria to make clinical prior authorization and appeal determinations in accordance with medical ... Pharmacy Specialist - Temporary Position from Mid-May to Mid-August ( Remote or Hybrid Option) **Cost Center:** 682891381 SHP- Pharmacy **Scheduled Weekly… more
- Molina Healthcare (Nicholasville, KY)
- …regulations, NCQA guidelines, and CMS standards. + Provides coordination and processing of pharmacy prior authorization requests and/or appeals. + Explains ... those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs… more
- Prime Therapeutics (Columbus, OH)
- …clients in all Medical Pharmacy programs such as Fee Schedule Management, Prior Authorization , Post Service Claim Edits, Site of Service and any additional ... decision we make. **Job Posting Title** Director, Specialty Clinical Solutions/Med Pharmacy exp required- REMOTE **Job Description Summary** Responsible for… more
- SSM Health (Madison, WI)
- …service experience through the provision of benefits investigations and conducting prior authorization services. Develops a thorough understanding of payer ... developing client-based relationships with clinical staff and patients, presenting pharmacy service options through customized financial analysis, and facilitating… more
- Elevance Health (Plano, TX)
- …pharmacy associates who facilitate patient access to pharmaceutical therapy through the prior authorization process. **How you will make an impact:** + ... **Manager Pharmacy ( Prior Authorizations)** A proud member...setting. Location: **This position will work a Hybrid Model ( remote and office). Ideal candidates must live within 50… more
- Health First (Rockledge, FL)
- …includes, all Formulary Exception, Prior Authorization and Administrative Authorization requests for both the pharmacy and medical benefit, as ... *Position Summary * Apply proper authorization requirements and pharmacy benefits for...and disease management. *Primary Accountabilities * 1. Apply proper authorization requirements to all prior authorization… more
- St. Luke's Health System (Meridian, ID)
- **Overview** At St. Luke's, Infusion Authorization Specialists are a pivotal role that involves extensive interaction with various internal and external ... governmental peer review organizations, and referring physicians' offices. **_This is a remote position that will require a 1-month training in Boise, Idaho._**… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- Summary This position is located within the Outpatient Pharmacy of the Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla, WA. This position is above ... the full performance level for Pharmacy Technicians and requires National Certification by either PTCB...incoming faxed prescription by naming and confirming Community Care authorization of care to include expiration date of service.… more
- Indian Health Service (Phoenix, AZ)
- …Health Service in the collection of Alternate Resources. Request and obtains prior authorization for various pharmaceutical products from insurance companies. ... Summary This position is located in the Pharmacy Department at the Phoenix Indian Medical Center,...accordance with IHS Telework Flexibilities Policy and Supervisory Approval prior to a job offer. Remote Work.… more
- G-TECH Services, Inc. (Detroit, MI)
- … Pharmacy * Experience in provider/member call center or helpdesk * Process prior authorization requests Required Skills/Experience - The rest of the required ... facing webtool. Preferred Skills/Experience - Optional but preferred skills/experience. Include: * Prior Authorization on Pt B specialty medications * Knowledge… more
- Elevance Health (Tucson, AZ)
- …outreach to patients and prescribers for resolution on open issues. + Processes prior authorization requests from physicians and ensures compliance with all ... ** Pharmacy Technician III- Escalations ( Pharmacy Tech...regulatory requirements; informs relevant parties of all prior authorization determinations. + Provides resolution to… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Residence in the middle Tennessee region is preferred. . KEY RESPONSIBILITIES + Evaluate prior authorization requests for key barrier + Determine best route for ... pharmacy challenges. More specifically this person will manage prior authorizations for primary care patients from initial request...medication access including prior authorization or alternative path + Review… more
- BrightSpring Health Services (Great Falls, MT)
- …customer chain. Duties include staff development and accountability, billing quality, Prior Authorization , Claim Overrides and customer service* Validate ... The ideal candidate will be a customer service focused Pharmacy Technician or someone who has worked in a...Work in conjunction with Account Management to communicate billing, Prior Authorization and Payer information with the… more
- Actalent (Tempe, AZ)
- Job Title: Pharmacy Technician Job Description Join our Prior Authorization Operations team as a Pharmacy Technician where you will process prior ... License and/or CPhT certification without restriction + Understanding of managed pharmacy benefit concepts including formularies, prior authorizations, edits,… more