- Texas Health Resources (Fort Worth, TX)
- …pharmacy required * 2 years of previous Retail Pharmacy experience, previous prior authorization processing and prescription benefit billing experience highly ... preferred. * Sterile IV Certification highly preferred * Proficiency in written and verbal English language, computers, the ability to adapt to various software systems, and basic math including conversions, proportions, ratios, and algebra. * The ability to… more
- CVS Health (Austin, TX)
- …work schedules will include holidays and evening hours **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care ... experience + Experience using MedCompass + Ambulatory surgery experience **Education** + Associates degree required + Bachelor's in Nursing preferred **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is:… more
- Baylor Scott & White Health (Temple, TX)
- …clients to explain Health Plan pharmacy benefits, assist with understanding the prior authorization process, and resolve claims processing and eligibility issues ... while adhering to department policies and procedures. This position advocates on behalf of the member and serves as a liaison between the Health Plan and stakeholders to identify root causes and address concerns. In addition, the Pharmacy Services Specialist 2… more
- Molina Healthcare (Fort Worth, TX)
- …pharmacies, and health plan providers in resolution of member prescription claim, prior authorization , and pharmacy service access issues. * Articulates pharmacy ... management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed. Required Qualifications * At least 2 years pharmacy technician experience, preferably supporting Medication Therapy Management (MTM), or equivalent… more
- Centene Corporation (Austin, TX)
- …visits, appropriate prescription drug spend, and mitigation of provider abrasion from prior authorization and inpatient management programs. + Collaborate with ... matrix partners to design, implement, and drive programs that align with and achieve Behavioral Health goals for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource allocation and… more
- Cardinal Health (Austin, TX)
- …enrollment /reimbursement activities, benefit investigations for product benefit coverage, prior authorization assistance, copay enrollment, and other patient ... services. + Oversee daily operations for patient access support contact center team of up to 15 team members and provides daily support ensuring team members can perform job responsibilities. + Oversee daily operations for quality performance monitoring team… more
- Abbott (Austin, TX)
- …Assist sites with Medicare, Medicare Advantage, Medicaid and Private Payor prior authorization , pre-determination, and appeal requests for subjects participating ... and enrolled in Abbott sponsored clinical trials. + Assist sites with claim submission and appeal processes and other related matters requiring a specialized knowledge of Medicare, Medicaid and Private Payer reimbursement procedures and requirements. + Heavy… more
- Baylor Scott & White Health (Johnson City, TX)
- …approaches** to reduce provider burden: + **RX Workgroup** (handles refill and prior authorization requests) + **RN Case Management** (continuity support for ... patients with chronic conditions) + **AI-powered support tools** to streamline care: + **Augmented Response Technology** (AI-generated responses to patient messages) + **Curation** (AI-generated diagnosis suggestions to support accurate coding) **About the… more
- Houston Methodist (Houston, TX)
- …compliance with industry standards. **FINANCE ESSENTIAL FUNCTIONS** + Ensures proper insurance authorization is obtained timely and accurately prior to the ... At Houston Methodist, the Insurance Authorization Specialist position is responsible for obtaining and...facilities, physician's, and department to ensure timely and accurate authorization of all services/visits. + Collaborate with internal and… more
- Texas A&M University System (College Station, TX)
- …University safety requirements. Export Control + This position will require export-control authorization prior to starting employment. + This position may ... facilities + Previous experience working in and supporting ACL-3 laboratory/environment + Prior experience in an animal research facility. + Deep understanding of… more