- US Tech Solutions (New York, NY)
- …conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical ... Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%) 4. Establishes and maintains communication, health… more
- Healthfirst (NY)
- **Duties & Responsibilities:** + **Monitor and review prior authorization requests for medications** + **Calculate appropriate billable units based on dosing, ... drug knowledge and disease state understanding for application to prior authorization reviews** + **Ensure prior...degree from an accredited school of pharmacy** + **Registered Pharmacist with a state license in good standing.** +… more
- University of Rochester (Rochester, NY)
- … pharmacist in medication dispensing. **ESSENTIAL FUNCTIONS** **_Clinical Staff Pharmacist - Medication Authorization and Distribution_** + Directs and ... hospital staff is conducted in an effective and professional manner. + Ensures pharmacist checks for all products requiring approval prior to dispensing,… more
- University of Rochester (Rochester, NY)
- …in an effective and professional manner. + Checks all products requiring a pharmacist approval prior to dispensing. + Participates in departmental Q/A processes ... who work in other areas of the department. **Medication Authorization and Distribution:** + Understands and follows departmental and...interest in ambulatory practice. + The newly-hired Level II pharmacist is someone with either prior (1… more
- Humana (Albany, NY)
- …conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization . This role involves evaluating complex clinical ... and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical… more
- Humana (Albany, NY)
- …Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization , formulary management and clinical programming + ... our caring community and help us put health first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical… more
- Mount Sinai Health System (New York, NY)
- …Appropriately checks all work conducted by non-licensed personnel requiring direct pharmacist supervision and authorization , eg, unit-dose cassette filling, IV ... Ensures rational drug therapy by reviewing inpatient and outpatient medication orders prior to dispensing. Evaluates new orders against existing patient profiles and… more
- Mount Sinai Health System (Brooklyn, NY)
- …+ Appropriately checks all work conducted by non-licensed personnel requiring direct pharmacist supervision and authorization , eg, unit-dose cassette filling, IV ... Ensures rational drug therapy by reviewing inpatient and outpatient medication orders prior to dispensing. Evaluates new orders against existing patient profiles and… more
- Highmark Health (Albany, NY)
- …**JOB SUMMARY** This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review ... RESPONSIBILITIES** + Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the… more
- University of Rochester (Rochester, NY)
- …information to submit prescriptions to the patient's insurance for approval including prior authorization , and helps enroll patients in financial assistance ... policies of the most common payors for the relevant administered drugs that require prior authorization (PA), and will be responsible for working with the … more