- US Tech Solutions (May, OK)
- …calls from physician or members regarding their pending, approved, or denied prior authorizations . **Responsibilities:** + Evaluate and review all prior ... **Duration: 6+ months contract** **Job Description:** + The clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected… 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
- US Tech Solutions (May, OK)
- …take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations , internally support the Prior Auth team and ... and telephony programs. + Minimum 2 years' recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a… 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
- 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
- US Tech Solutions (May, OK)
- …+ Since the job duties consist of reviewing and completing criteria based on prior authorizations , candidates with that experience are preferred. **Skills:** + ... This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + Reviewing and… more
- US Tech Solutions (May, OK)
- …data entry, data management, and reporting. **Experience:** + * Review criteria-based prior authorizations following policy and procedure. + * Provide on-call ... Responsibilities include answering inbound phone calls, processing cases and electronic authorizations , loading authorizations , and making follow-up phone calls… more
- US Tech Solutions (May, OK)
- …with resume and provide license number. **Responsibilities:** + Review criteria-based prior authorizations following policy and procedure. + Provide on-call ... member services department . + Refer cases not meeting clinical criteria to the Pharmacist and MD team(s). + Shift priorities while exhibiting a high level of… more
- Highmark Health (Oklahoma City, OK)
- …concerning oral, injectable and infusion medication requests, and drug claim edits/ prior authorizations . By reviewing member claims history, clearly defines ... workflow within the department. + Prioritize requests for drug authorizations or denials. + Review of prior ...additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document… more
- Actalent (Tulsa, OK)
- …and triaging coverage determination requests submitted by providers and determining whether a pharmacist review is required. You will play a key role in obtaining ... verbal authorizations , requesting detailed clinical information from prescribers, and approving...triage coverage determination requests from providers. + Determine if pharmacist review is required for requests. + Obtain verbal… more
- Walgreens (Owasso, OK)
- …needed to correct inaccurate orders. + Under the supervision of the pharmacist -in-charge, verifies all pharmacy shipments are posted for products physically received ... and pharmacy scan outs. + Under the supervision of the pharmacist -in-charge,completes pharmacy inventory activities including but not limited to pharmacy recalls… more
- BrightSpring Health Services (Oklahoma City, OK)
- …Amerita. + Ensure that insurance verification is completed and authorization is in place prior to giving the referral to a Pharmacist . + Maintain confidentiality ... clear and within Amerita's scope of service. + Obtain authorizations and re- authorizations as required by payers. + Enter patient demographic, insurance… more
- Ascension Health (Tulsa, OK)
- …Assist the clinical pharmacist in the review of medication profiles, prior authorizations , and documentation of clinical interventions. **Why Join Our Team** ... Ascension St. John has been serving Northeast Oklahoma with compassionate, personalized care since 1926. Join more than 7,000 associates and find a rewarding healthcare career at one of our 6 hospitals and numerous other sites of care. When you join our care… more