- 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 (Austin, TX)
- … pharmacist in a PBM setting. * Current experience working within commercial Prior Authorizations in PBM (Caremark) * Experience using clinical resources, eg, ... with CVS Health. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians and prior… more
- MetroHealth (Valley View, OH)
- …and more than 20 health centers.** **Summary:** **Processes and obtains authorizations for medication therapy requests initiated by MetroHealth Clinicians. Serves as ... Pharmacy benefits verifications and payor preauthorization. Provides clinical oversight for Prior Authorization Specialists and is a resource for providers for… 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
- Point32Health (MA)
- …The Clinical Pharmacist consults as required with Medical Directors (MD) on prior authorizations (PA) that fail to meet medical necessity guidelines. **Job ... direction of the Pharmacy Utilization Management (UM) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and managing the daily caseload… 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
- 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 ... Friday, 8 am - 5:00 pm As a Research Pharmacist at the Cedars-Sinai Angeles Clinic in Los Angeles...**Education:** + Doctor of Pharmacy (PharmD) **Licenses/Certification:** + Ca Pharmacist license + BLS card within 180 days **Experience:**… more
- Evolent (Pittsburgh, PA)
- …support including maintenance of Medical Oncology clinical Q&As for provider portal, prior authorizations , lists, regimens, scope diagnoses, case review and ... the mission. Stay for the culture. **What You'll Be Doing:** **Oncology Pharmacist , Medical Pharmacy** Support and Development + Deliver provider and pharmacist… more
- Actalent (Austin, TX)
- …be utilizing your clinical skills to complete utilization management reviews ( Prior authorizations , Coverage Exceptions, Quantity Limit exceptions, and more). ... and contracts are evaluated every 6 months for extension. Skills Pharmacist , Retail, Clinical, Pharmacy Benefits Management, Pharmacy, Prior authorization,… more
- Cedars-Sinai (Beverly Hills, CA)
- …will assist in clinical reviews of specialty prescriptions, conducting oncology prior authorizations and managing benefit investigations, supporting oncology ... residency or equivalent practice experience. **License/Certification/Registration Requirements:** + Current pharmacist licensure in the State of California. **What else… more
- Nuvance Health (Norwalk, CT)
- …inquiries. 4. Answering drug information requests from providers. 5. Obtaining prior authorizations . 6. Consulting prescribers about prescription problems. 7. ... *Description* Summary: The intern pharmacist would assist the full-time pharmacy staff during times of pharmacist PTO, as an intern may perform many of the… more
- UHS (Walton, NY)
- …state laws and pharmacy protocols + Manage and verify insurance claims and prior authorizations to facilitate medication access + Maintain accurate and complete ... Position OverviewUnited Health Services (UHS) is seeking a dedicated Pharmacist to join our pharmacy team. The Pharmacist... Pharmacist to join our pharmacy team. The Pharmacist will ensure the safe and accurate administration of… more
- UHS (Johnson City, NY)
- …state laws and pharmacy protocols + Manage and verify insurance claims and prior authorizations to facilitate medication access + Maintain accurate and complete ... Position OverviewUnited Health Services (UHS) is seeking a dedicated Pharmacist to join our pharmacy team. The Pharmacist... Pharmacist to join our pharmacy team. The Pharmacist will ensure the safe and accurate administration of… 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
- Logan Health (Kalispell, MT)
- …such as diabetes, high cholesterol, and hypertension. + Assist with medication prior authorizations and financial assistance applications to improve medication ... Excellence. Logan Health's is looking for a full-time Ambulatory Pharmacist to join their team! This vital position will...you are: We are looking for a seasoned, experienced pharmacist for this impactful position. Our ideal candidate will… more
- Atlantic Health System (Morristown, NJ)
- …services and medication access, including medication histories, medication education, prior authorizations , specialty pharmacy navigation, and formulary agent ... The Cystic Fibrosis (CF) Clinical Pharmacist position will provide pharmacotherapeutic support to the...fibrosis in the ambulatory care setting. The CF clinical pharmacist will ensure optimal medication use, support adherence, and… more
- Catholic Health Services (Rockville Centre, NY)
- …items, etc. + Collaborates with the interdisciplinary team to facilitate medication prior authorizations as needed for continuation of care. + Evaluate ... award. Job Details Transition of Care (TOC) The Transitions of Care Pharmacist will work collaboratively with healthcare professionals to maximize positive clinical… more
- Actalent (Chattanooga, TN)
- … authorization processes Job Responsibilities + Review and process medication-related prior authorizations , pharmacy appeals, and member grievances + Conduct ... Pharmacist - Coverage Review Specialist (Remote) Location: Must...timelines + Build and maintain decision trees in the prior authorization system + Ensure denial rationales and decision… 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