- Excellus BlueCross BlueShield (Rochester, NY)
- …see is right for you, we encourage you to apply! Job Description: Summary: The Pharmacy Prior Authorization Technician performs functions as permitted by ... law including the initial level processing and review of prior authorization requests for both pharmacy reviews and medical specialty drug reviews. These… more
- CenterWell (Albany, NY)
- …skills. **Preferred Qualifications** + Pharmacy Benefit Management experience + Prior Authorization experience Travel: While this is a remote position, ... community and help us put health first** The Clinical Pharmacy Technician assists the interdisciplinary CIT team...act as facilitator to resolve them with regard to prior authorization or obtaining medications. + Attend… more
- Molina Healthcare (NY)
- …**Essential Job Duties** * Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; ... JOB DESCRIPTION **Job Summary** Provides support for pharmacy technician activities. Contributes to overarching...Accurately enters approvals or denials of requests. * Facilitates prior authorization requests within established pharmacy… more
- CDPHP (Latham, NY)
- …and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed pharmacist. The ... direct supervision of a licensed pharmacist, the Managed Care Pharmacy Technician ( Pharmacy Tech) is...customers. + Must be conscientious, efficient and accurate in prior authorization , exception and medical/Rx necessity review… more
- City of New York (New York, NY)
- …Support pharmacist with Quality assurance projects as assigned. - Assist Pharmacist in the Pharmacy unit with prior authorization approvals as well as ... which best serve New Yorkers The Bureau is requesting to hire a City Pharmacy Technician to work in one of our public health clinics to provide health service… more
- Molina Healthcare (Buffalo, NY)
- …services, pharmacies, and health plan providers in resolution of member prescription claim, prior authorization , and pharmacy service access issues. * ... and others as needed. Required Qualifications * At least 2 years pharmacy technician experience, preferably supporting Medication Therapy Management (MTM), or… more
- Centene Corporation (Hawthorne, NY)
- …and standards **Education/Experience:** High school diploma or equivalent. 2+ years of pharmacy technician or medical office (ie biller, coder, office ... assistance, or prior authorization /certification) experience. Familiarity with drugs commonly used to treat chronic/debilitating illnesses.… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Medical University Hospital retail pharmacy revenue through provision of prior authorization services at Upstate Medical University Hospital clinics. Observe ... and medical necessity of medication use based on established criteria. Obtain prior authorization from intermediaries and payers, including managed care… more
- University of Rochester (Rochester, NY)
- …including pharmacists, pharmacy technicians, medical/clinical staff, and central prior authorization staff. External interactions include third party payors, ... duties as required, including work relating to the Intake Pharmacy Access Representative ** Prior Authorization ...ASHP accredited training program or equivalent experience as a pharmacy technician , or Certification from a nationally… more
- Mount Sinai Health System (New York, NY)
- …but not limited to, oversight of staff responsible for the prompt attention to prior authorization of specialty medications, oversight of the quality of work ... telephone correspondence and EHR documentation. **Qualifications** 3+ years of retail pharmacy technician experience or related health care administrative, and… more
- Highmark Health (Albany, NY)
- …clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to ... + Prioritize requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. + Recommend staffing adjustments… more
- Healthfirst (NY)
- …in good standing (ie, PTCB, NHA) or registered or licensed Pharmacy Technician in good standing** + **Experience conducting prior authorization reviews** ... **Duties & Responsibilities:** + **Reviews prior authorization requests and units for medications requested under the medical benefit** + **Assesses… more
- Molina Healthcare (Yonkers, NY)
- …Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains ... plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. *… 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
- KPH Healthcare Services, Inc. (Oneonta, NY)
- …improvement initiatives. + Responsible for monitoring adjudication queue(s) and facilitate prior authorization process for customers + Responsible for ensuring ... appropriateness of therapy, labs or other questions/concerns and provide support for prior authorization , financial assistance, and prescription fill and renewal… 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
- Northwell Health (New York, NY)
- …to help facilitate the filling of prescriptions, handle/resolve rejections, and obtain prior authorization which will expedite prescriptions into the workflow. + ... School Diploma or equivalent, required. + Graduate of a recognized Pharmacy Technician Training Program or PTCB Certification (CPHT), required. + Current license… more
- Northwell Health (New York, NY)
- …to help facilitate the filling of prescriptions, handle/resolve rejections, and obtain prior authorization which will expedite prescriptions into the workflow. ... Qualification High School Diploma or equivalent, required. Graduate of a recognized Pharmacy Technician Training Program or PTCB Certification (CPHT), required.… more
- St. Mary's Healthcare (Amsterdam, NY)
- …copay cards, foundation grants, patient assistance programs). + Perform medication prior authorization support activities and communicate with providers and ... Education, Training & Experience: + High school diploma/GED required. + Certified Pharmacy Technician (CPhT) through PTCB or NHA required within six (6) months… more
- University of Rochester (Rochester, NY)
- …access drugs in assigned clinics. Collaborates with clinical staff to acquire prior authorization for relevant providers, investigates benefits, enrolls patients ... major payers for the relevant clinic-administered drugs that require prior authorization (PA) and is responsible for...records preferred **LICENSES AND CERTIFICATIONS** + PHAR-C - Certified Pharmacy Tech Certified pharmacy technician … more