- CVS Health (Jefferson City, MO)
- …Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist Position supporting ... Prior Authorization. An active OK, AZ or TX pharmacist license that is in good standing is required...production team environment 3+ years experience working as a pharmacist . + Knowledge of clinical program components,… more
- Elevance Health (St. Louis, MO)
- … authorization decision trees within the workflow tool + Assists in implementing clinical programs within the prior authorization space + Verifies member, ... requests from physicians' offices and ensures compliance with Medicare and Medicaid requirements; inform relevant parties of all prior authorization… more
- Elevance Health (St. Louis, MO)
- …member care through proper medication management. + Perform weekly clinical prior authorizations and coverage determinations for Medicaid and Medicare. + ... or clinical aspects of the CarelonRx pharmacy program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review… more
- Highmark Health (Jefferson City, MO)
- …to obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document ... concerning oral, injectable and infusion medication requests, and drug claim edits/ prior authorizations. By reviewing member claims history, clearly defines the… more