• Pharmacist, Utilization Management (UM)…

    Molina Healthcare (Tucson, AZ)
    …those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/Management staff work to ensure that Molina...responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and… more
    Molina Healthcare (10/16/25)
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  • Clinical Staff Pharmacist Remote

    Prime Therapeutics (Phoenix, AZ)
    …processing and documenting of Utilization Management requests (ie formulary exceptions, prior authorization , step therapy, quantity limit exceptions) for ... + Responsible for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs,… more
    Prime Therapeutics (09/17/25)
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  • Sr/Care Manager, Patient Support Services…

    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
    IQVIA (09/23/25)
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  • Clinical Service Representative

    CVS Health (Phoenix, AZ)
    …professional and courteous phone assistance to all callers through the criteria based prior authorization process. Certified Pharmacy Technicians (CPhT) are ... attention to detail and the ability to multi-task effectively. ** Remote Work Requirements:** + Prior remote...I, Level II, and Level III positions within the Prior Authorization (PA) team is a structured… more
    CVS Health (10/15/25)
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  • Field Reimbursement Manager

    Amgen (Phoenix, AZ)
    …order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms + Review ... coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization , appeal, and/or claims resolution + Educate… more
    Amgen (10/09/25)
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  • Work from Home Clinical Pharmacist

    Adecco US, Inc. (Mesa, AZ)
    …a computer, reviewing prior authorizations and receiving phone calls from prior authorization pharmacy technicians and/or healthcare providers to gather, ... Adecco Healthcare & Life Sciences is hiring remote pharmacists! For this role you must reside...guideline criteria, and provide decisions on prior authorization requests. . Collaborate with pharmacy technicians… more
    Adecco US, Inc. (10/03/25)
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  • Pharmacist

    US Tech Solutions (AZ)
    …could be required. (10%) **Experience:** + Pharmacist License of Current State + Prior Authorization Experience. + Medicare Experience + Experience working in ... **Job Title:** **Pharmacist** **Location: Remote ** **Duration: 12+ months contract** **Job Description:** +...healthcare. **Skills:** + Prior Authorization . + Medicare. + … more
    US Tech Solutions (10/17/25)
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  • Formulary Operations Management Professional

    Humana (Phoenix, AZ)
    …help facilitate clinical medication review decision making. + Responsible for operationalizing prior authorization criteria into Humana systems in alignment with ... Humana's Pharmacy and Therapeutics Committee and in collaboration with healthcare...team setting to achieve goals and meet deadlines + Prior demonstrated experience with process improvement and documentation **Desired… more
    Humana (10/18/25)
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