- Adecco US, Inc. (Phoenix, AZ)
- …computer, reviewing prior authorizations and receiving phone calls from prior authorization pharmacy technicians and/or healthcare providers to gather, ... clarify, and assess detailed clinical information. . Interpret medical and pharmacy policy criteria... questions, interpret guideline criteria, and provide decisions on prior authorization requests. Ensure determinations are clinically… more
- US Tech Solutions (AZ)
- …required. (10%) **Experience:** + Pharmacist License of Current State + Prior Authorization Experience. + Medicare Experience + Experience working in ... (20%) + Reviews cases in progress and provides a Clinical decision regarding Prior Authorizations, Tier Exceptions...healthcare. **Skills:** + Prior Authorization . + Medicare. + … more
- Humana (Phoenix, AZ)
- …necessity and comprehensive medication reviews for prescriptions requiring prior authorization . This role involves evaluating complex clinical scenarios and ... help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for...holiday in 2025** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for… more
- Highmark Health (Phoenix, AZ)
- …and implementation of utilization management programs including but not limited to: prior authorization , dose and duration edits, quantity limits, step-care ... and stakeholders across the organization. Key responsibilities will include clinical review, assisting in navigating a complex regulatory environment, working… more
- Prime Therapeutics (Phoenix, AZ)
- …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
- Molina Healthcare (Phoenix, AZ)
- …Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services access issues. + Articulates ... (such as, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen… more
- Banner Health (Tucson, AZ)
- …to overcome barriers to medication access, with focused expertise in third-party prior authorization and billing processes for pharmacy benefits. Assist patients ... Associate's or bachelor's degree in business, healthcare or related field preferred. Prior authorization experience in specialty or retail pharmacy preferred.… more
- Banner Health (Tucson, AZ)
- …to overcome barriers to medication access, with focused expertise in third-party prior authorization and billing processes for pharmacy benefits. Assist patients ... Associate's or bachelor's degree in business, healthcare or related field preferred. Prior authorization experience in specialty or retail pharmacy preferred.… more
- Actalent (Phoenix, AZ)
- …+ Customer service skills. + Data entry proficiency. + Experience with Prior Authorization processes. + Registered Pharmacy Technician. Additional Skills & ... insurance company. This role is 100% remote and involves reviewing Prior Authorizations for determinations, managing health plans, and handling various types… more
- HonorHealth (AZ)
- …Osborn Medical Center, 7400 E Osborn Rd, Scottsdale Hours: Full-Time Evenings Prior Inpatient Experience Preferred Sign-on-Bonus Available! Looking to be part of ... urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization,… more