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REMOTE Adherence Pharmacist
Insight Global
The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines,…
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Pharmacist, Population Health
Navitus Health Solutions, LLC
Participate in the Coverage Determination (Certification, Prior Authorization, Medical Exception, Exception to Coverage, etc.) process when needed
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Manager, Clinical Pharmacy Operations
Centene Management Company LLC
Key Details: This position is fully remote. The ideal candidate will have people leadership experience and a strong background in managed care or PBM clinical pharmacy operations, including…
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Vaccines Specialist, Health and Science Professional - Ocala, FL
Pfizer Inc
Relevant Healthcare/Scientific roles (e.g., RN, Pharmacist, PT, OT, etc.)
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Staff Pharmacist - Accredo - Remote (AZ, FL, IN, OH, PA)
Accredo Health Group Inc
This is a remote position. Candidates must reside and be licensed in one of the following states: Arizona, Florida, Indiana, Ohio or Pennsylvania.
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Prior Authorization Pharmacist
Medix Staffing Solutions
In this remote clinical role, you will evaluate prior authorization requests for formulary and non-formulary medications. You will leverage evidence-based guidelines and regulatory…
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Remote Clinical Pharmacist
Actalent
Job Title: 100% Remote PharmacistJob DescriptionThe Pharmacist performs comprehensive final prior authorization reviews and ensures safe, compliant medication use in accordance with all…
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PRN Pharmacist Reviewer – Medicare Part D Formulary Criteria Review
Rainmakers Strategic Solutions
…Centers for Medicare & Medicaid Services (CMS) reviewing the prior authorization (PA) and step therapy (ST) criteria that Medicare Part D plan sponsors submit for approval. Pharmacist…
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Expert: Healthcare (Contract, Remote)
Patronus AI, Inc.
…dosing. They manage formularies, therapeutic interchange and drug prior authorizations. Typical titles: Clinical Pharmacist, Hospital Pharmacist, Community Pharmacist, Pharmacy Manager,…
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Appeals Clinical Specialist
MedImpact Healthcare Systems Inc.
Provide drug information support. Research and provide clinical literature documentation to support prior authorization decisions as indicated. May include preparation of Pharmacy and…
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Pharmacy Tech/CSR
NTT Data Americas, Inc.
Primary duties include taking Prior Auth in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria…
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Pharmacy Technician Customer Service Representative
NTT Data Americas, Inc.
…phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all…
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Remote Pharmacy Tech I
NTT Data Americas, Inc.
This position handles high-volume inbound calls, accurately documents prior authorization reviews, and escalates clinical questions and judgment-based decisions to the pharmacist team.…
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Pharmacy Tech
Randstad USA
Top National Healthcare company is hiring Certified Pharmacy Technician to work in their Prior Authorization call center.
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Pharmacy Tech
Randstad USA
Top National Healthcare company is hiring Pharmacy Technician to work in their Prior Authorization call center.
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Pharmacy Services Rep (Pharm Tech)
Medix Staffing Solutions
Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information
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Pharmacy Tech
Randstad USA
Top National Healthcare company is hiring Certified Pharmacy Technician to work in their Prior Authorization call center.
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Pharmacy Tech
Randstad USA
Top National Healthcare company is hiring Pharmacy Technician to work in their Prior Authorization call center.
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Formulary Administration Specialist
MedImpact Healthcare Systems Inc.
Basic PBM knowledge, Drug Information and Prior Authorization experience preferred;
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LPN/LVN Prior Authorization Nurse
Randstad USA
Market leading managed care organization looking for remote/work from home Prior Authorization LPN/LVNs!
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Clinical Quality Pharmacist
MedImpact Healthcare Systems Inc.
The Clinical Quality Pharmacist is responsible for performing clinical audits of Prior Authorization (PA) and Appeals staff and Utilization (UM) delegate(s) across all lines of business.…
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Appeals Clinical Specialist
MedImpact Healthcare Systems Inc.
Provide drug information support. Research and provide clinical literature documentation to support prior authorization decisions as indicated. May include preparation of Pharmacy and…
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Formulary Administration Pharmacist
MedImpact Healthcare Systems Inc.
…management positioning decisions (quantity limits, step edit and prior authorization guidelines) resulting from newly approved indications, therapeutic agents, patent expirations, FDA…
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Pharmacy Tech
Randstad USA
Top National Healthcare company is hiring Certified Pharmacy Technician to work in their Prior Authorization call center.
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Pharmacy QA Specialist
Dane Street, LLC
Verify adherence to client-specific workflows, including prior authorization, appeals, and exception processes