- 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)
- …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)
- …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 ... 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)
- …based role that conducts clinical reviews of medical data collected to perform prior authorization for commercial and specialty medications. + The clinical ... pharmacist will apply clinical knowledge to plan approved criteria...prior authorizations. **Responsibilities:** + Evaluate and review all prior authorization requests and render coverage determinations… more
- US Tech Solutions (May, OK)
- …that conducts criteria based & clinical review of medical data collected to perform prior authorization as per policy and procedure. + The Pharmacist ... urgent PA request as needed. **Responsibilities:** + Evaluate and review all prior authorization requests and render coverage determinations based on clinical… more
- Humana (Oklahoma City, OK)
- …conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization . This role involves evaluating complex clinical ... and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical… 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)
- …06+ months contract **Note:** + Ideal candidates must have experience of Prior Authorization , Medicare Part D and Pharmacy Benefit Management experience. ... and Sunday. Set Rotation. **Job Description:** + As a Pharmacist Advisor you will be directly supporting Medicare Part...+ **Previous pharmacy experience in Medicare Part D, PBM, Prior Authorization is required.** + Appropriate state… 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)
- …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)
- …+ 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
- 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
- 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
- Highmark Health (Oklahoma City, OK)
- …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. +...additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document… 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
- Actalent (Tulsa, OK)
- …providers, and members of coverage determination request decisions. Essential Skills + Prior authorization experience. + Data entry proficiency. + Pharmacy ... and triaging coverage determination requests submitted by providers and determining whether a pharmacist review is required. You will play a key role in obtaining… more
- Option Care Health (Oklahoma City, OK)
- …as needed + Checks final product for particulate matter and container integrity prior to presenting to pharmacist for final check + Labels compounded ... of emergency breakdowns + Gathers and checks compounding material prior to its entry into the clean room +...compounding. BASIC QUALIFICATIONS + Remains aware of the supervisory pharmacist 's role and responsibility for the integrity of medications… 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