- CVS Health (Albany, NY)
- …Certified Oncology Pharmacist (BCOP) required + 2+ years clinical pharmacist experience, inclusive of prior authorization experience + Knowledge of ... based & clinical review of medical data collected to perform prior authorization as per policy and procedure. The Pharmacist /Clinician will apply … more
- CVS Health (Glen Cove, NY)
- …the pharmacy team in doing so, to resolve barriers to patient care, including prior authorization , formulary changes, copay concerns, etc. + Ensures the pharmacy ... to care and helping to improve patient outcomes through pharmacist delivered clinical care such as testing...the state where the District is located - required ** Prior Relevant Work Experience** **:** 1 to 3 years… 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
- 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 ... State Pharmacy License and interest in hospital practice. - The newly-hired Level II pharmacist is someone with either prior ()1 year) of relevant acute care… more
- Independent Health (Buffalo, NY)
- …that there are no appeal tasks to complete, the BA RPh will assist the Supervising Pharmacist , Prior Authorization in any tasks that are deemed necessary for ... fosters growth, innovation and collaboration. **Overview** The Benefit Administration Pharmacist (BA RPh) shall be responsible to research initial...the PBD Prior Authorization and PBD Benefit Administration teams.… more
- The Cigna Group (Elmsford, NY)
- **This is a PRN role as a staff pharmacist in our backend fulfillment center.** **This role is worksite dependent and is located onsite at our Elmsford, NY ... 8:30 am - 5 pm Eastern Time.** **POSITION SUMMARY** The Staff Pharmacist , Per Diem interprets physicians' prescriptions, contacts doctors or other prescribers and/or… more
- Molina Healthcare (Buffalo, 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
- WMCHealth (Valhalla, NY)
- …teams + Exercise sound judgement in the escalation of clinical questions to the pharmacist on duty + Prior Authorization & Billing Management: + Initiate ... sound judgement in the escalation of clinical questions to the pharmacist on duty + Prior Authorization & Billing Management: + Initiate and manage … 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
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …Diabetes Management, Medication Therapy Management, and Aprexis. + Maintain and update clinical criteria associated with prior authorization software as ... + Review prior authorizations and appeals against the formulary and clinical criteria for ProAct members as needed. + Develop and present educational programs… more
- Finger Lakes Community Health (Geneva, NY)
- …reduce prescriber burden. + Track refill trends and propose updates as needed. Prior Authorization Support + Gather documentation, complete forms, and follow up ... insurers to support timely medication approvals. + Help minimize delays related to prior authorization backlogs. Other Duties: + Perform other related duties as… more
- CDPHP (Albany, NY)
- …formulary coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed ... part of that experience. Under the direct supervision of a licensed pharmacist , the Managed Care Pharmacy Technician (Pharmacy Tech) is responsible for administering… more
- Catholic Health Services (Centereach, NY)
- …Act as advocate for patients where needed; coordinating insurance barriers, prior authorization and denials, leveraging charitable foundations, state programs, ... pharmacy staff. Establish patient profiles, including third-party payor(s) and clinical information. Coordinate with physician practices to identify patients,… more