- Molina Healthcare (Columbus, OH)
- …Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains ... including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization...information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and… more
- Highmark Health (Columbus, OH)
- …clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to ... requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. +...billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and… more
- Veterans Affairs, Veterans Health Administration (Cleveland, OH)
- …and obtaining documentation needed to process prior authorization requests. Responsibilities VA Careers - Pharmacy : https://youtube.com/embed/Fn\_ickNBEws ... Summary The Community Care Pharmacy Technician is responsible for the receiving, assessing...in Electronic Health Record (EHR). Reviews EHR to determine authorization to receive Community Care. Communicates with patients concerning… more
- Bon Secours Mercy Health (Youngstown, OH)
- …are recognized for clinical and operational excellence. **Reports to Title:** Pharmacy Supervisor, Manager, or Director **Summary of Primary Function/General Purpose ... hospital) and/or outpatient (ambulatory; retail; home infusion) services. The Certified Pharmacy Technician will have a variety of job responsibilities within the… more
- Cardinal Health (Columbus, OH)
- …care and timely access to necessary services + Assist in obtaining insurance, prior authorization , and appeal requirements and outcomes + Help patients ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more