- CVS Health (NY)
- … Pharmacist with CVS Health. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians ... experience using clinical resources, eg, Micromedex, Lexicomp, Clinical Pharmacology * Prior authorization ... authorization pharmacy technicians and/or providers for clinical information. * Active pharmacist license that… more
- Molina Healthcare (NY)
- …pharmacy/health plan providers, Molina staff and others as needed. * Performs prior authorization reviews of high-cost medications and deferred authorization ... subject matter expertise for pharmacy Medication Therapy Management (MTM) and clinical pharmacy services activities. Contributes to overarching pharmacy strategy for… more
- US Tech Solutions (New York, NY)
- …collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria ... **Job Summary:** The clinical pharmacist is an operation based...phone calls and escalations from physicians or patients regarding Prior Authorization (50%) 4. Establishes and maintains… more
- University of Rochester (Rochester, NY)
- …in an effective and professional manner. + Checks all products requiring a pharmacist approval prior to dispensing. + Participates in departmental Q/A processes ... Pharmacy License and interest in ambulatory practice. + The newly-hired Level II pharmacist is someone with either prior (1 year) of relevant… more
- Molina Healthcare (Yonkers, NY)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction),… more
- Mount Sinai Health System (Brooklyn, NY)
- …+ Appropriately checks all work conducted by non-licensed personnel requiring direct pharmacist supervision and authorization , eg, unit-dose cassette filling, IV ... Ensures rational drug therapy by reviewing inpatient and outpatient medication orders prior to dispensing. Evaluates new orders against existing patient profiles and… more
- University of Rochester (Rochester, NY)
- …to optimize medication therapy and patient outcomes. The centralized order verification pharmacist will also have a working knowledge of the operational aspects of ... shifts, evening shifts, weekends, and holidays. **ESSENTIAL FUNCTIONS** **_Medication Authorization and Distribution:_** + Understand and follow departmental and… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …for various cost containment/ clinical programs + Assist in the completion of prior authorization reviews as needed + Provide Help Desk support, where ... **Overview** **Scope of Responsibilities:** Assist with the day-to-day operations of the Clinical Pharmacist and clinical department of ProAct. Works under… more
- University of Rochester (Rochester, NY)
- … clinical employees at various levels including pharmacists, pharmacy technicians, medical/ clinical staff, and central prior authorization staff. External ... information to submit prescriptions to the patient's insurance for approval including prior authorization and helping enroll patients in financial assistance… more
- University of Rochester (Rochester, NY)
- … clinical employees at various levels including pharmacists, pharmacy technicians, medical/ clinical staff, and central prior authorization staff. External ... insurance coverage determination, patient out of pocket determination, determination of prior authorization requirements. The PAR will communicate with the… more
- University of Rochester (Rochester, NY)
- …information to submit prescriptions to the patient's insurance for approval including prior authorization , and helps enroll patients in financial assistance ... policies of the most common payors for the relevant administered drugs that require prior authorization (PA), and will be responsible for working with the … more
- University of Rochester (Rochester, NY)
- …information to submit prescriptions to the patient's insurance for approval including prior authorization , and helps enroll patients in financial assistance ... policies of the most common payors for the relevant administered drugs that require prior authorization (PA), and will be responsible for working with the … more
- CDPHP (Latham, NY)
- …formulary coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed ... and external customers. + Must be conscientious, efficient and accurate in prior authorization , exception and medical/Rx necessity review processing. +… more
- Highmark Health (Albany, NY)
- …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
- Independent Health (Buffalo, NY)
- …record data and create reporting structure. + Assist in the maintenance of Prior Authorization forms. + Maintain positive facilitative communication and problem ... and to track and report on individual and aggregate clinical information. The Adherence Advocate will apply positive communication...falls out of the acceptable, defined range to a Pharmacist for case review. + Utilize defined assessments assigned… more
- Highmark Health (Buffalo, NY)
- …then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review. Ensures all accurate information is ... identified cases that require additional notification to member, provider, and/or pharmacist .At times, outreach to providers and/or pharmacists may be required to… more