- Prime Therapeutics (Phoenix, AZ)
- …Liaison - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates… more
- Molina Healthcare (Scottsdale, AZ)
- …for remote Certified Pharmacy Technicians. These roles will be in our Prior Authorization department. You will review prior auth requests that are ... Duties** + Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional… more
- Actalent (Phoenix, AZ)
- …experience in retail, hospital, or mail order pharmacy . + Current state Pharmacy Technician license. + Prior authorization experience. Additional Skills ... We are hiring for a 100% REMOTE Pharmacy Technician ASAP! Leading healthcare...involves tracking and triaging all coverage determination requests for prior authorizations and Medicare Part D recipients. The successful… more
- Cardinal Health (Phoenix, AZ)
- …either at a health system or payor) highly preferred + Experience with prior authorization approvals and medical/ pharmacy benefit billing & coding, ... to secure coverage and reimbursement rate for advanced therapy / CGT products. + ** Prior Authorizations:** Manage the prior authorization process for CGT… more
- Prime Therapeutics (Phoenix, AZ)
- …functions, DUR committees and responsibilities. + Supports elevated customer service and prior authorization inquiries specific to assigned accounts. + Manages ... those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Georgia Medicaid Clinical Account Manager - … more
- IQVIA (Phoenix, AZ)
- …correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care Managers may also ... breakthroughs in the real world. **Position Summary:** AllCare Plus Pharmacy , an IQVIA company, is seeking a Care Manager!...assistance programs and/or varied adherence support. This is a ** remote ** position. **Hours:** Must be available for an 8… more
- Highmark Health (Phoenix, AZ)
- …**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
- Cognizant (Phoenix, AZ)
- …Excellent problem-solving and communication skills **These will help you stand out** + Prior experience in healthcare or pharmacy systems (RxClaim) + Familiarity ... testing and provide technical support throughout the project lifecycle **Work model: Remote ** We strive to provide flexibility wherever possible. Based on this… more
- Humana (Phoenix, AZ)
- …Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization , formulary management and clinical programming + ... scope and complexity ranging from moderate to substantial. The Pharmacy Director, internally known as a Clinical Pharmacy...on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- CenterWell (Phoenix, AZ)
- …Specialty Care to lead strategy and execution for our referral management, payer prior authorization , and specialist network solutions. This role is critical to ... Define and track KPIs related to referral throughput, network utilization, and prior authorization efficiency; use data to drive continuous improvement. +… more