- Elevance Health (Indianapolis, IN)
- …Representative I** will be responsible for coordinating cases for precertification and prior authorization review. **How you will make an impact:** + Managing ... **Utilization Management Representative I** **Virtual:** This role enables associates to...provides authorization for inpatient admission, outpatient precertification, prior authorization , and post service requests. +… more
- Highmark Health (Indianapolis, IN)
- …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 necessary. +… more