- Cambia Health Solutions, Inc (Boise, ID)
- …assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary -related operations and other operational processes which require knowledge and ... government programs personnel and customer service. These pharmacy issues include formulary drug coverage, appeal and reconsideration claim status, and pricing for… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …staff, pharmacy personnel, and other hospital staff.Obtain and process non- formulary medications per NGMC pharmacy department policies.Check assigned areas for ... counts. Work with pharmacy leadership as necessary to identify and resolve formulary issues.Assist with Med Carousel order processing and picking during the course… more
- Tenet-AZ Region (Tucson, AZ)
- …prevent and resolve potential and actual drug related problems.Recommends formulary alternatives when appropriate.Compounds and dispenses medications for accurate ... facilitate care.Accurately enters/verifies medication orders and performs final check prior to dispensing of all medications, including sterile products,… more
- Health First (Rockledge, FL)
- …internal staff and PBM, make recommendations to committee regarding new medications, formulary placement of medications, and prior authorization criteria (if ... applicable). 4. Post the HFHP Drug Formulary and prior authorization criteria in coordination with the Pharmacy Services Staff. 5. Review pharmacy prior … more
- Amergis (Ovid, NY)
- …generic brands when available. Should there be a need to prescribe outside the Formulary , prior authorization must be obtained from the Regional Nurse Manager. + ... In determining resident health problems, the Consultant shall consult with staff and other contracted/non-noncontracted healthcare practitioners as necessary on acute and/or chronic medical/mental health. Requirements: + DEA - BLS certification + NY State… more
- Conduent (Elkridge, MD)
- …in Maryland (required). + Minimum of three (3) years of experience supporting formulary , prior authorization, benefits design, and clinical information. + Expert ... when necessary. + Uphold clinical goals and guidelines for our pharmacy prior authorization program. + Evaluate new therapies and methodologies to identify trends… more
- CareOregon (Portland, OR)
- …Technician Certification. Core responsibilities include customer service, claims processing, prior authorizations, formulary exceptions, appeals, grievances, and ... materials to members, providers or pharmacies, letters & mailings, and reports. Prior Authorizations (PA) and Formulary Exceptions + Verify member's plan… more
- Sanford Health (Sioux Falls, SD)
- … prior authorization and identify any potential missing information. Enter prior authorizations and formulary exception requests into referral form. Review ... Members, pharmacies, and providers concerning pharmacy issues such as coverage, prior authorization, step therapy, networks, and overrides. Review incoming prior… more
- University of Rochester (Rochester, NY)
- …providers. - Conducts phone calls for verification/confirmation, insurance medication formulary and pharmacy benefits clarification, prior authorizations, and ... REDCap is desirable (preferred). Trauma-Informed Care training/certification/knowledge desired (preferred). Prior experience with home visiting interventions valued (preferred). Spanish… more
- Beth Israel Lahey Health (Boston, MA)
- …programs. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic administered or ... infusion medications through evaluating necessity of prior authorization and identification of formulary alternatives. Obtains initial and renewal insurance… more
- Beth Israel Lahey Health (Norwood, MA)
- …2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic administered or ... infusion medications through evaluating necessity of prior authorization and identification of formulary alternatives. 3. Obtains initial and renewal insurance… more
- BrightSpring Health Services (Morton Grove, IL)
- …by maintaining a high productivity level and an error-free workproduct. + Maintain formulary documents and tools. Qualifications + Prior data entry experience. + ... Familiarity with pharmacy systems. + Familiarity with standard pharmacy concepts, practices, and procedures. + Exceptionally strong verbal communication skills, with special emphasis on effective telephone correspondence. + Familiarity with Microsoft Excel. +… more
- The Cigna Group (Morris Plains, NJ)
- …SUMMARY:** The Program Management Advisor will provide consultation to custom formulary clients through contract interpretation and rebate financial modeling. In ... to identify strategic opportunities for clients to optimize their formulary to drive value for both internal and external...employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states… more
- Prime Therapeutics (Columbus, OH)
- …procedures, policies, guidelines, and work instructions. **Job Description** + Provides prior -authorization services for formulary drugs, develops programs to ... other clinical personnel in assessing treatment guidelines. May participate in formulary development and management. Supports the national Pharmacy and Therapeutics… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …Market Access account managers and the contracted account to gain alignment on formulary product placement and compliance and to recover previously paid rebate or ... discounts in the event of noncompliant formulary findings. Reporting to the Sr. Director - Contract...and conditions of contract. Requests and obtains supporting documentation ( prior authorizations, step edits, etc.) as need to complete… more
- Stanford Health Care (Palo Alto, CA)
- …[see Standardized Procedure: Administering, Ordering, Furnishing or Prescribing of Drugs; Formulary Protocol] 6. Orders and collects specimens for routine laboratory ... Standardized Procedure: Administering, Ordering, Furnishing or Prescribing of Drugs; Formulary Protocol] Medications that are not FDA-approved or are...an accredited college or university + Note: PAs hired prior to July 1, 2012 are not subject to… more
- CVS Health (Austin, TX)
- …with CVS Health. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians and prior authorization ... within the designated service level agreements. - Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria… more
- Bristol Myers Squibb (Great Falls, MT)
- …targeted accounts and gaining meaningful access to all levels of formulary decision-makers to advance a financially responsible access position of company-promoted ... to act on those opportunities. The priority will be to secure a formulary position for our lead investigational product, KarXT, and future assets. Your timely… more
- Elevance Health (St. Louis, MO)
- …**Build the Possibilities. Make an Extraordinary Impact.** The **Manager Pharmacy Prior Authorizations** is responsible for managing a team of pharmacy associates ... who facilitate patient access to pharmaceutical therapy through the prior authorization process. **How you will make an impact:**...but are not limited to: + Ensures adherence to formulary and member benefit structures to provide service that… more
- CVS Health (Phoenix, AZ)
- …to the next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist Position supporting ... Medicaid Prior Authorization. The position is remote. An active AZ...as a pharmacist. Demonstrated understanding of clinical program components, formulary designs, and prescription benefit trends. Preferred QualificationsMedicaid or… more
