- 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
- CVS Health (Oklahoma City, OK)
- …days of hire (90 days for each) if needed. + Demonstrated experience with prior authorizations in the managed care environment + Demonstrated experience with ... the next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist Position… more
- 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 ... based role that conducts clinical reviews of medical data collected to perform prior authorization for medications. + The clinical pharmacist will apply clinical… 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
- Adecco US, Inc. (Tulsa, OK)
- …Responsibilities:** . Serve as a clinical resource working from a computer, reviewing prior authorizations and receiving phone calls from prior authorization ... clinical questions, interpret guideline criteria, and provide decisions on prior authorization requests. . Collaborate with pharmacy technicians and/or prescribers… 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
- US Tech Solutions (May, OK)
- …computer system data entry, data management, and reporting. + Review criteria-based prior authorizations following policy and procedure. + Provide on-call after ... license number. + You will provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Specialty Medical Prior … more
- Walgreens (Tulsa, 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
- US Tech Solutions (May, OK)
- …The UM Nurse Associate I is responsible for reviewing and completing criteria-based prior authorizations in compliance with company policies and procedures. This ... role provides after-hours nurse availability for urgent prior authorization requests, supports the PA team and member...services, and refers cases requiring clinical review to the Pharmacist or MD team. **Duties** + Answer inbound nurse… more
- Walgreens (Oklahoma City, OK)
- …Medicaid, and all other third-party payers, as well as the facilitating of prior authorizations on behalf of prescribers. **Operations** + Works with the ... BS in Pharmacy or PharmD Degree from an accredited educational institution. + Current pharmacist license in the state where the site is located or willing to obtain… more