- Molina Healthcare (Cleveland, OH)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
- Molina Healthcare (OH)
- …Job Duties * Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional ... requests. * Accurately enters approvals or denials of requests. * Facilitates prior authorization requests within established pharmacy policies and procedures. *… more
- Molina Healthcare (OH)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
- Merck (Columbus, OH)
- …and/or education to HCP accounts on patient access, including benefit verification, prior authorization process, appeals process, and patient support programs in ... B, Medicaid, commercial) and related access processes, including benefit verification, prior authorization , and appeal processes * Expertise in pharmaceutical… more
- Molina Healthcare (OH)
- …team of medical directors and behavioral health clinicians responsible for prior authorization , inpatient concurrent review, discharge planning, care management, ... develops medical director staff and team members as needed. + Ensures authorization decisions are rendered by qualified personnel without influence from fiscal or… more
- Molina Healthcare (OH)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
- Molina Healthcare (Columbus, OH)
- …Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims ... not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with… more
- Cleveland Clinic (Cleveland, OH)
- …monitoring quality control programs in assigned area. + Conduct third party prior authorization requests when needed. + Monitor program performance, including ... future caregiver include: + Experience dealing with third party insurance and prior authorization process **Physical Requirements:** + Typical physical demands… more
- Molina Healthcare (Akron, OH)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
- Actalent (Columbus, OH)
- …providers, and members of coverage determination request decisions. Essential Skills + Prior authorization experience. + Data entry proficiency. + Pharmacy ... coverage determination request decisions. + Respond to client inquiries regarding authorization approvals and PBM online applications. + Refer coverage determination… more
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