- US Tech Solutions (May, OK)
- …and telephony programs. + Minimum 2 years' recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a ... 11am to 730pm EST** **Job Description:** + Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and… more
- WMCHealth (Valhalla, NY)
- …by assisting in the preparation of medications for dispensation by the pharmacist , managing inventory, coordinating prior authorizations , and providing ... by assisting in the preparation of medications for dispensation by the pharmacist , managing inventory, coordinating prior authorizations , and providing… more
- Trinity Health (Dublin, OH)
- … Pharmacist with medication or patient care related issues + Assist the Pharmacist with prior authorizations for medications + Documents the distribution ... of medication for proper use and reimbursement in accordance with department policy. **Minimum Qualifications:** + Education: High school graduation or equivalent + Licensure / Certification: Approved Pharmacy Technician Certification and active registration… more
- US Tech Solutions (May, OK)
- …calls from physicians or members regarding their pending, approved, or denied prior authorizations . **Responsibilities:** + Ensure accuracy of case setup and ... based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply… more
- Actalent (Eagan, MN)
- …utilize your clinical skills to complete utilization management reviews, including prior authorizations , coverage exceptions, and quantity limit exceptions. You ... + Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree. + Current pharmacist license in good standing with the State Board of Pharmacy. + Two years… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …drug management + Perform medical necessity reviews for formulary exceptions and prior authorizations according to the Medicare Part D defined guidelines ... The Clinical Pharmacist in addition to being responsible for the...+ Make recommendations on utilization management edits such as Prior Authorization, Step Therapy and Quantity Limits + Provide… more
- US Tech Solutions (AZ)
- …(20%) + Reviews cases in progress and provides a Clinical decision regarding Prior Authorizations , Tier Exceptions and Non-Formulary requests (50%) + Performs ... pharmacist availability could be required. (10%) **Experience:** + Pharmacist License of Current State + Prior ...+ Pharmacist License of Current State + Prior Authorization Experience. + Medicare Experience + Experience working… more
- CVS Health (Chandler, AZ)
- …medications. + Confers with healthcare providers and insurance companies to obtain prior authorizations and facilitate reimbursement for specialty medications. + ... change as business needs change. Exciting opportunity for a Pharmacist to join our Specialty Mail Service Pharmacy located...therapy in the United States. If you are a Pharmacist , and enjoy helping people on their path to… more
- Evolent (Phoenix, AZ)
- …support including maintenance of Medical Oncology clinical Q&As for provider portal, prior authorizations , lists, regimens, scope diagnoses, case review and ... mission. Stay for the culture. **What You'll Be Doing:** **Oncology Pharmacist , Medical Pharmacy** **Collaboration Opportunities:** The Oncology Pharmacist role… more
- Cedars-Sinai (Los Angeles, CA)
- …years of experience and knowledge. + Supports the process of completing medication prior authorizations as needed. + Documents patient progress and outcomes for ... advance cancer care. Days/Hours: Monday - Friday, day shift As a Research Pharmacist Coordinator at the Cedars-Sinai Angeles Clinic in Los Angeles, California on… more
- Actalent (Miami, FL)
- …clinical skills to independently complete utilization management reviews such as prior authorizations , coverage exceptions, and quantity limit exceptions. Join ... months for extension. Responsibilities + Conduct utilization management reviews including prior authorizations and coverage exceptions. + Work independently and… more
- US Tech Solutions (May, OK)
- …based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply ... plan approved criteria for prospective and concurrent reviews of cases. authorizations . **Responsibilities:** 1. Collaborates with the CRU Technician to process… more
- Cedars-Sinai (Los Angeles, CA)
- …at goal, discontinuation of medication). + Supports the process of completing medication prior authorizations as needed. + Documents of patient progress and ... care. Days/Hours: Monday - Friday, day shift As a Pharmacist at the Cedars-Sinai Angeles Clinic in Los Angeles...Requirements: + Doctor of Pharmacy (PharmD) Licenses/Certifications: + CA Pharmacist License + Basic Life Support by American Heart… more
- Trinity Health (Nampa, ID)
- …distributive and operational tasks including specialty pharmacy care coordination, prior authorizations , and financial assistance. Demonstrated customer focused ... access, require additional educational needs and would benefit from clinical pharmacist follow up between primary care of specialty provider visits. **SKILLS,… more
- Sutter Health (Santa Rosa, CA)
- …efforts, and educates co-workers around medication reconciliation, medication renewals, and prior authorizations . + Mentors and fosters a constructive teaching ... EXPERIENCE:** 3 years recent relevant experience **CERTIFICATION & LICENSURE:** PharmD - Pharmacist - California State Board of Pharmacy OR PHARMR - Registered … more
- Sutter Health (Mountain View, CA)
- …and educates co-workers around: ◦ Medication reconciliation ◦ Medication renewals ◦ Prior authorizations DEPARTMENT OPERATIONS * Actively reports data analytics ... 5 years recent relevant experience **CERTIFICATION & LICENSURE:** PHARMD-Licensed Pharmacist OR PHARMR-Registered Pharmacist **SKILLS AND KNOWLEDGE:**… more
- US Tech Solutions (May, OK)
- …(20%) + Reviews cases in progress and provides a Clinical decision regarding Prior Authorizations , Tier Exceptions and Non-Formulary requests (50%) + 6. Performs ... and duties as assigned including on call and after-hours pharmacist availability could be required. (10%) **Experience:** + Minimum...(10%) **Experience:** + Minimum 1 year of experience in Prior Authorization & Medicare Part D although 2-5 years… more
- Ochsner Health (New Orleans, LA)
- …outcomes. Provides drug information to patients and healthcare providers. Works to resolve prior authorizations and all insurance billing on behalf of the ... **Work Experience** Required - None Preferred - 2 years experience as pharmacist Experience in specialty pharmacy **Certification** Required - License to practice… more
- Penn Medicine (Philadelphia, PA)
- …life's work? Penn Medicine is seeking a per diem Ambulatory Clinical Pharmacist Retail with Penn Presbyterian Medical Center - Outpatient. Responsibilities: + ... processes prescriptions through insurance company and handles DUR rejects, pre- authorizations , etc.; performs final check on all prescriptions, ensuring accurate… more
- Dignity Health (Phoenix, AZ)
- …Collaborate with financial and pharmacy staff to facilitate the timely acquisition of prior authorizations for medications. Serve as a preceptor for pharmacy ... and Medical Center is seeking a highly motivated and detail-oriented Clinical Pharmacist to join our dynamic team serving both our comprehensive Dignity Health… more