- CVS Health (Baton Rouge, LA)
- …+ 5+ years of clinical experience + 1+ year(s) of utilization management , concurrent review and/or prior authorization experience + 5+ years ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in… more
- Sutherland Global Services (Baton Rouge, LA)
- …Requests + Authorizations + Status Inquiries + Denial Rationale + Utilization Management Appeals + Prior Authorization Verification + Eligibility and ... attitude + Multi-tasking skills with a strong attention to detail + Time Management skills + Sufficient Internet speeds while connected to a Remote Desktop Session… more
- Highmark Health (Baton Rouge, LA)
- …the Organization's management programs including but not limited to: prior authorization , dose and duration edits, quantity limits, step-care edits, ... in the development and implementation of utilization management programs including but not limited to: prior... management programs including but not limited to: prior authorization , dose and duration edits, quantity… more
- Prime Therapeutics (Baton Rouge, LA)
- … and analysis. Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancements). Identifies opportunities for ... functions, DUR committees and responsibilities. Supports elevated customer service and prior authorization inquiries specific to assigned accounts. Directly… more
- Prime Therapeutics (Baton Rouge, LA)
- …+ Manages current clients in all Medical Pharmacy programs such as Fee Schedule Management , Prior Authorization , Post Service Claim Edits, Site of Service ... client presentations + Leads evaluation and identification opportunities for improved management of Medical benefit drugs through clinical research and analytics… more