- CVS Health (St. Paul, MN)
- …Pharmacist with CVS Health. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians and prior ... within the designated service level agreements. - Evaluate and review all prior authorization requests and render coverage determinations based on clinical… more
- Humana (St. Paul, MN)
- …a part of our caring community and help us put health first** The Pre- Authorization Nurse 2 reviews prior authorization requests for appropriate care ... refer to Tier III care management as needed. * Perform prior authorization reviews according to established HUMANA GOVERNMENT BUSINESS contractual requirements… more
- Robert Half Office Team (Eden Prairie, MN)
- …an hour once per month; would be calling out to let them know the results of the prior authorization if it was approved or denied; just on the drug piece - Have ... of incoming fax transmittals and index them into the appropriate Prior Authorization System PAS workbaskets Research and identifying member provider and drug… more
- Prime Therapeutics (St. Paul, MN)
- …Clinical Pharmacy Technician **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by ... staff, medical management staff and/or pharmacists. + Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected… more
- Highmark Health (St. Paul, MN)
- …claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network ... Prioritize requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. + Recommend staffing adjustments necessary to… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …entered into Epic * Verifies accurate insurance information and partners with the prior - authorization team to determine if prior - authorization ... Gathers medical records, CPT Codes, Imaging, and supporting documents required for the prior - authorization process * Obtains and scans surgical consent forms *… more
- Prime Therapeutics (St. Paul, MN)
- …Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected… more
- Blue KC (Workman, MN)
- …available resources to promote optimal, cost-effective outcomes. Transplant only: Provides prior authorization for, coordinates, and individually manages all ... work appropriately. Additional duties for Transplant only: + Provides prior authorization of the transplant and manages individual member cases. Reviews… more
- Cardinal Health (St. Paul, MN)
- …is to provide a detailed outline of clearance criteria as well as prior authorization and advocacy identification for procedures and medications scheduled to ... for benefit investigation as well as clinical clearance for prior authorization and medical necessity + Extensive patient education/counseling to determine… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …or Medicaid eligibility vendor as appropriate * Determines whether a service requires a prior authorization . If so, documents appropriately and sends to prior ... Collection tool to provide patient with estimate of out of pocket expenses for services prior to date of service and attempts to collect any out of pocket expenses *… more