- US Tech Solutions (May, OK)
- **Job Description:** + Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This ... be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure....required with at least two years experience as a pharmacist in Managed care environment. + Must have an… more
- US Tech Solutions (May, OK)
- …hours pharmacist availability could be required. **Experience:** + Experience as a Prior Authorization Pharmacist is required. **Skills:** + Prior ... role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply… more
- US Tech Solutions (May, OK)
- …conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical ... and after hours pharmacist availability could be required. **Experience:** + Prior authorization experience preferred. + Medicare Part D experience required… more
- US Tech Solutions (May, OK)
- …conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical ... Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%) 4. Establishes and maintains communication, health… more
- US Tech Solutions (May, OK)
- …between 11am to 730pm EST** **Job Description:** + Evaluate and review all prior authorization requests and render coverage determinations based on clinical ... ap-proval & denial management processes. + Collaborate with the technicians and prior authorization team members to process refer- rals, including answering… more
- CVS Health (Oklahoma City, OK)
- …* Board Certified Oncology Pharmacist (BCOP) required * 2+ years clinical pharmacist experience, inclusive of prior authorization experience * Knowledge ... business needs. PRIMARY DUTIES AND RESPONSIBILITIES: 1. Evaluate and review all prior authorization requests and render coverage determinations based on clinical… more
- US Tech Solutions (May, OK)
- **Job Description:** + Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone ... assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely...all clinical questions, escalations and judgement calls to the pharmacist team. + The Rep I, Clinical Services will… more
- US Tech Solutions (May, OK)
- …and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of ... all clinical questions, escalations and judgement calls to the pharmacist team. The Rep I, Clinical Services will also...the leadership team. Work closely with providers to process prior authorization (PA) and drug benefit exception… more
- US Tech Solutions (May, OK)
- …pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on ... + Refer cases not meeting clinical criteria to the Pharmacist and MD team(s). + Shift priorities while exhibiting...each prior authorization . + Train and mentor representatives… more
- US Tech Solutions (May, OK)
- …other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each ... * Refer cases not meeting clinical criteria to the Pharmacist and MD team(s). + * Shift priorities while... prior authorization . + * Train and mentor... prior authorization . + * Train and mentor representatives on the… more
- CenterWell (Oklahoma City, OK)
- … Extension (AAE), Drug Medically Accepted Indication (MAI), Fast Pass (FP), Prior Authorization Hub (PAHub), and Non-Formulary Guide (NFG). This individual ... first** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist Program & Automation Strategy Expert supports government program strategies and… more
- Intermountain Health (Oklahoma City, OK)
- …demonstrates consistent application of knowledge and skills in assisting the pharmacist in execution of appropriate, safe, efficacious, efficient, and cost-effective ... of pharmacy practice under the supervision of a licensed pharmacist or technician supervisor and is an integral part...of pharmacy services while under the supervision of a pharmacist as required by state of practice and job… more
- Prime Therapeutics (Oklahoma City, OK)
- …processing and documenting of Utilization Management requests (ie formulary exceptions, prior authorization , step therapy, quantity limit exceptions) for ... + Responsible for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs,… more
- US Tech Solutions (May, OK)
- …This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This ... be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure....required with at least two years experience as a pharmacist . **About US Tech Solutions:** US Tech Solutions is… more
- US Tech Solutions (May, OK)
- …availability could be required. (10%) **Experience:** + Minimum 1 year of experience in Prior Authorization & Medicare Part D although 2-5 years is preferred ... **Skills:** + Prior Authorization + Medicare Part D **Education:** + Bachelor's Degree Required, Pharm D Preferred **About US Tech Solutions:** US Tech Solutions… more
- US Tech Solutions (May, OK)
- …+ This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + Reviewing ... and completing criteria based on prior authorization as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM (Pharmacy Benefits… more
- Prime Therapeutics (Oklahoma City, OK)
- …Pharmacy Technician Sr **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected… more
- US Tech Solutions (May, OK)
- …and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of ... all clinical questions, escalations and judgement calls to the pharmacist team. The Tech I will also assist with...to 3 years of related work experience. **Skills:** + Prior Authorization + Call handling experience. **Education:**… more
- US Tech Solutions (May, OK)
- …and courteous phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely and accurate documentation ... all clinical questions, escalations and judgement calls to the pharmacist team. + The pharmacy Tech will also assist...working in PBM on managed care environments **Skills:** + Prior Authorization + Medicare and Medicaid +… more
- US Tech Solutions (May, OK)
- …and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of ... preferably in healthcare, social services, or a similar service position. **Skills:** + Prior Authorization **Education:** + High School diploma or GED is… more