- CVS Health (Boston, MA)
- … Pharmacist with CVS Health. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians ... setting. * Current experience within Caremark Prior Authorization team. * Experience using clinical resources,... authorization pharmacy technicians and/or providers for clinical information. * Active pharmacist license that… more
- Humana (Boston, MA)
- …necessity and comprehensive medication reviews for prescriptions requiring prior authorization . This role involves evaluating complex clinical scenarios and ... help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for...per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for… more
- Humana (Boston, MA)
- …necessity and comprehensive medication reviews for prescriptions requiring prior authorization . This role involves evaluating complex clinical scenarios and ... our caring community and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical… more
- CVS Health (Boston, MA)
- …do it all with heart, each and every day. **Position Summary** The Prior Authorization colleague takes in-bound calls from providers, pharmacies, members, etc. ... phone assistance to all callers through the criteria based prior authorization process. You will maintain complete,...results (seniors, pharmacists, appeals, etc). + Identify and elevate clinical inquiries to the pharmacist team as… more
- Prime Therapeutics (Boston, MA)
- …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
- Beth Israel Lahey Health (Burlington, MA)
- … staff, pharmacy staff, and third party payers for issues regarding prior authorization approvals, ambulatory infusion reimbursement and Patient Assistance ... 2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic administered or… 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
- Highmark Health (Boston, MA)
- …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
- Beth Israel Lahey Health (Needham, MA)
- …and pharmacy buyer when inventory levels are low. + Receives requests for Prior Authorization from pharmacy or Tier Exception/PAF request from patient, completes ... information in the medical record. Under the supervision of a pharmacist , and according to departmental policies, procedures and guidelines, the Medication… more