- CVS Health (Springfield, IL)
- …indications and review clinical documentation in support of prior authorization reviews. You will also provide internal pharmacist support to the PA ... heart, each and every day. **Position Summary** As a clinical pharmacist , you will review Prior...and review clinical documentation in support of prior authorization reviews. The primary function of… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …GS 11: $132,636-$172,419 GS 12: $140,601-$182,789 Responsibilities Clinical : Performs clinical reviews and adjudicates prior authorization drug requests ... Summary The Clinical Pharmacist serves as a primary...primary responsibility of this role will be to adjudicate prior authorization drug requests (PADRs) in accordance… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …VA regulations, state laws, and federal laws governing the practice of pharmacy. The Clinical Pharmacist will be under the supervision of the Outpatient Pharmacy ... resolving all third party issue rejects. 5. Reviews all prior authorization drug requests (PADR) for formulary...met when determining the grade of candidates. GS 12 Clinical Pharmacist (Full Performance Level) Experience or… more
- Adecco US, Inc. (Downers Grove, IL)
- …computer, reviewing prior authorizations and receiving phone calls from prior authorization pharmacy technicians and/or healthcare providers to gather, ... clarify, and assess detailed clinical information. . Interpret medical and pharmacy policy criteria... questions, interpret guideline criteria, and provide decisions on prior authorization requests. . Collaborate with pharmacy… more
- CVS Health (Buffalo Grove, IL)
- …plans. **Utilization Management** + Understand UM development and management, including prior authorization , step therapy, quantity limits, and formulary ... and regulatory partners. **Required Qualifications:** + PharmD or equivalent clinical pharmacy degree. + Active pharmacist license...care experience. + 3+ years of relevant UM or prior authorization experience. + Strong understanding of… more
- Actalent (Illinois City, IL)
- …Retail, Clinical , Pharmacy Benefits Management, Pharmacy, Prior authorization , Pharmd, Compounding Top Skills Details Pharmacist ,Retail, Clinical ... your clinical skills to complete utilization management reviews ( Prior authorizations, Coverage Exceptions, Quantity Limit exceptions, and more). You will… more
- Rush University Medical Center (Chicago, IL)
- …site of care. c. Assist in assessing insurance coverage and assist in prior authorization for medications (when necessary) in advance of discharge. Other ... Board Certification Board of Oncology Pharmacy Specialty Certification (BCOP) prior to or within 18 months of hire *...and SCT programs i. Participate in coverage of Heme/Onc Clinical Pharmacist pager. Other responsibilities (Department of… more
- Prime Therapeutics (Springfield, IL)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 6 months dispensing or retail experience ... Pharmacy Technician **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Prime Therapeutics (Springfield, IL)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience ... Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Walgreens (Deerfield, IL)
- …evaluating diagnoses and other clinical criteria to complete requests for prior authorization , specialty care specific to the department and patient needs ... specific department, other responsibilities as judgment or necessity dictate. + Reviews prior authorization criteria for specified payers related to defined… more
- Highmark Health (Springfield, IL)
- …claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network ... requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. +...and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as… more
- Option Care Health (Itasca, IL)
- …as needed + Checks final product for particulate matter and container integrity prior to presenting to pharmacist for final check + Labels compounded ... and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health...of emergency breakdowns + Gathers and checks compounding material prior to its entry into the clean room +… more