- Molina Healthcare (Dayton, OH)
- …include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/ Management staff work to ensure that Molina members,...CMS standards. + Provides coordination and processing of pharmacy prior authorization requests and/or appeals. + Explains… more
- Elevance Health (Mason, OH)
- …. **How you will make an impact:** + Maintain clinical criteria for prior authorization reviews _for custom and standard criteria sets_ + _Collaborate ... Carelon as topics arise from the client_ + Address prior authorization inquiries _from client by conducting...from Pharmacy & Therapeutics meetings + Coordinate policy and utilization management updates with formulary + _Collaborate… more
- Molina Healthcare (Columbus, OH)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes… more
- Molina Healthcare (Columbus, OH)
- …services to Molina members with ASD and other related disorders. * Approves prior authorization requests for BHT treatment by reviewing Behavioral Health Therapy ... Masters Degree in Behavior Analysis or a related field. **Preferred Experience** Utilization Management experience Health Plan/MCO work experience To all current… more
- Molina Healthcare (Columbus, OH)
- …Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services access issues. + Articulates ... and state laws. Jobs in this family include those involved in formulary management (such as, reviewing drug/provider utilization patterns and pharmacy costs … more
- Molina Healthcare (Cleveland, OH)
- …physician leadership and expertise in the performance of prior authorization , inpatient concurrent review, discharge planning, case management and ... years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review,… more
- Army National Guard Units (OH)
- …National Guard. The purpose of this position is to perform maintenance production management , to achieve or maintain desired production levels, to serve as an ... plans and monitors progress of accomplishments. Using readiness, production and management reports available from the current automation support program and/or… more
- Army National Guard Units (OH)
- …storage and distribution, cataloging or supply identification systems, property utilization , or other related supply activities including those associated with ... the Property Book operations in the area of inventory and storage management , and equipment coordination. Ensures the property book sections periodically perform a… more
- Prime Therapeutics (Columbus, OH)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... functions, DUR committees and responsibilities. + Supports elevated customer service and prior authorization inquiries specific to assigned accounts. + Manages… more
- Army National Guard Units (Perry, OH)
- …procedures; and in accordance with needs and priorities, ensures maximum safety utilization . Assists units in solving problems that arise during training. Must be ... units to conduct specialized/classified training events using an extensive risk management program. Makes recommendations to the training center commander and using… more