- Prime Therapeutics (Providence, RI)
- …for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including ... processing and documenting of Utilization Management requests (ie formulary exceptions, prior authorization , step therapy, quantity limit exceptions) for… more
- Point32Health (Canton, MA)
- …to our members, partners, colleagues and communities. **Job Summary** The Senior Clinical Pharmacist is responsible for the development and maintenance of ... requirements and to meet Point32Health's corporate priorities. The Senior Clinical Pharmacist also oversees the structure and...+ Pharmacy Programs: + Recommend placement of drugs in prior authorization (PA), step-therapy prior … more
- Prime Therapeutics (Providence, RI)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience ... Pharmacy Technician Sr **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Beth Israel Lahey Health (Westwood, MA)
- …**Essential Responsibilities:** 1. Understands product and payer reimbursement landscape and prior authorization guidelines and processes. 2. Collects and ... reviews all data needed pharmacy and/or medical for prior authorization approvals. 3. Resolves insurance related...provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate. 5. Serves as the… more
- Option Care Health (Cranston, RI)
- …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