- CVS Health (Des Moines, IA)
- …indications and review clinical documentation in support of prior authorization reviews. You will also provide internal pharmacist support to the PA ... heart, each and every day. **Position Summary** As a clinical pharmacist , you will review Prior...and review clinical documentation in support of prior authorization reviews. The primary function of… more
- Prime Therapeutics (Des Moines, IA)
- …for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including ... processing and documenting of Utilization Management requests (ie formulary exceptions, prior authorization , step therapy, quantity limit exceptions) for… more
- Molina Healthcare (Des Moines, IA)
- …pharmacy/health plan providers, Molina staff and others as needed. * Performs prior authorization reviews of high-cost medications and deferred authorization ... subject matter expertise for pharmacy Medication Therapy Management (MTM) and clinical pharmacy services activities. Contributes to overarching pharmacy strategy for… more
- Molina Healthcare (Des Moines, IA)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction),… more
- Prime Therapeutics (Des Moines, IA)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 6 months dispensing or retail experience ... Pharmacy Technician **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Prime Therapeutics (Des Moines, IA)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience ... Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Highmark Health (Des Moines, IA)
- …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… more