• Remote - Prior Authorization

    Actalent (Phoenix, AZ)
    …+ Prior Authorizations + Insurance Verifications Qualifications: + 2+ year of Prior Authorization pharmacy experience is Mandatory + Pharmacy ... Quick Hiring for Remote Pharmacy Technician Job Description: + Order Entry for new/refill medications. + Respond to customer inquiries as necessary. + Assist in… more
    Actalent (07/19/25)
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  • Clinical Pharmacist - Medicaid Prior

    CVS Health (Phoenix, AZ)
    …other Windows based computer applications. * Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical ... Pharmacy programs administered within the Medicaid, 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 (07/16/25)
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  • Pharmacy Technician Remote (PST…

    Molina Healthcare (Tucson, AZ)
    …those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs ... pharmacies, and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services access issues. + Articulates … more
    Molina Healthcare (07/20/25)
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  • Remote Pharmacy Technician

    Actalent (Phoenix, AZ)
    …entry and customer service. + Registered Pharmacy Technician and Certified Pharmacy Technician credentials. + Prior authorization experience. Additional ... Job Title: Remote Pharmacy Technician Job Description ...technicians will operate in an EST timezone, primarily reviewing Prior Authorizations for coverage determination within a Pharmacy more
    Actalent (07/13/25)
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  • Supervisor, Clinical Pharmacy /MTM…

    Molina Healthcare (Mesa, AZ)
    …those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs ... **Job Description** **Job Summary** Molina Pharmacy Services/Management staff work to ensure that Molina...These staff may also be involved in providing utilization management/ prior authorization services as needed. * Supervises… more
    Molina Healthcare (07/09/25)
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  • Pharmacy Technician, Clinical/MTM…

    Molina Healthcare (Phoenix, AZ)
    …Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services access issues. + ... **Job Summary** Molina Healthcare is hiring for several Pharmacy Technicians. These roles are 100% Remote and require you be licensed either State or Nationally.… more
    Molina Healthcare (06/25/25)
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  • Pharmacy Technician

    Intermountain Health (Phoenix, AZ)
    …to termination, at the hiring manager's discretion. **Preferred** + Prior Authorization processing preferred **Physical Requirements:** **Physical Requirements** ... **Job Description:** The Pharmacy Technician demonstrates consistent application of knowledge and...is required. Work may be performed on site or remote as appropriate to practice site. + Ability to… more
    Intermountain Health (07/18/25)
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  • Medication Therapy Management (MTM) Specialist…

    Prime Therapeutics (Phoenix, AZ)
    …Specialist - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates… more
    Prime Therapeutics (06/25/25)
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  • Clinical Account Manager - Georgia PDL…

    Prime Therapeutics (Phoenix, AZ)
    …functions, DUR committees and responsibilities. + Supports elevated customer service and prior authorization inquiries specific to assigned accounts. + Manages ... **Job Posting Title** Clinical Account Manager - Georgia PDL - Remote **Job Description** Innovative business clinician accountable for building and maintaining… more
    Prime Therapeutics (04/24/25)
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  • Sr/Care Manager, Patient Support Services…

    IQVIA (Phoenix, AZ)
    …correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care Managers may also ... breakthroughs in the real world. **Position Summary:** AllCare Plus Pharmacy , an IQVIA company, is seeking a Care Manager!...assistance programs and/or varied adherence support. This is a ** remote ** position. **Hours:** Must be available for an 8… more
    IQVIA (07/04/25)
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  • Case Manager

    Cardinal Health (Phoenix, AZ)
    …and/or Medical Claims billing and Coding work experience + 1-2 years experience with Prior Authorization and Appeal submissions + Ability to work with high ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more
    Cardinal Health (07/16/25)
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  • Formulary Operations Management Professional

    CenterWell (Phoenix, AZ)
    …help facilitate clinical medication review decision making. + Responsible for operationalizing prior authorization criteria into Humana systems in alignment with ... Humana's Pharmacy and Therapeutics Committee and in collaboration with healthcare...team setting to achieve goals and meet deadlines + Prior demonstrated experience with process improvement and documentation **Desired… more
    CenterWell (07/19/25)
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  • Patient Navigator

    Cardinal Health (Phoenix, AZ)
    …billing and Coding work experience is preferred + 1-2 years of experience with Prior Authorization and Appeal submissions + Must be able to manage multiple ... healthcare providers regarding the patient journey. + Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier. +… more
    Cardinal Health (07/16/25)
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  • Pharmacist

    US Tech Solutions (AZ)
    …could be required. (10%) **Experience:** + Pharmacist License of Current State + Prior Authorization Experience. + Medicare Experience + Experience working in ... **Job Title:** **Pharmacist** **Location: Remote ** **Duration: 12+ months contract** **Job Description:** +...healthcare. **Skills:** + Prior Authorization . + Medicare. + … more
    US Tech Solutions (07/18/25)
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  • Reimbursement Coordinator

    Cardinal Health (Phoenix, AZ)
    …and pharmacy insurance benefit practices, preferred + 1-2 years experience with Prior Authorization and Appeal submissions, preferred + Ability to work with ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more
    Cardinal Health (06/21/25)
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  • Reimbursement Solutions Analyst

    Cardinal Health (Phoenix, AZ)
    …is to provide a detailed outline of clearance criteria as well as prior authorization and advocacy identification for procedures and medications scheduled to ... to representatives for benefit investigation as well as clinical clearance for prior authorization and medical necessity + Extensive patient education/counseling… more
    Cardinal Health (07/18/25)
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  • Reimbursement Coordinator

    Cardinal Health (Phoenix, AZ)
    …and pharmacy insurance benefit practices, preferred + 1-2 years' experience with Prior Authorization and Appeal submissions, preferred + Ability to work with ... patient population + Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the… more
    Cardinal Health (06/21/25)
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  • Bilingual Case Manager

    Cardinal Health (Phoenix, AZ)
    …care and timely access to necessary services + Assist in obtaining insurance, prior authorization , and appeal requirements and outcomes + Help patients ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more
    Cardinal Health (07/18/25)
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  • Director, Physician Leadership - Medical Directors…

    Humana (Phoenix, AZ)
    …outcomes of our members. + _Outcomes_ : Characterize the impactable drivers of prior authorization and Success in driving consistent and quality outcomes for ... the enterprise (eg, with Clinical Operations, Markets, Care Management, Analytics, Pharmacy , etc.) to develop discrete, high-value strategies and to ensure execution… more
    Humana (07/18/25)
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  • Patient Services Representative (Must Be Located…

    TEKsystems (Phoenix, AZ)
    …+ 2+ years healthcare experience, specialty referral experience, and outside of pharmacy referrals. + Prior call center experience strongly preferred + ... Schedule: Mon-Fri 5a-6:30p (AZ time) Location : Fully Remote - Will need to go onsite on...terminology, Insurance verification, insurance benefit knowledge, referral processing, and authorization experience required. + This role focuses on Complex… more
    TEKsystems (07/18/25)
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