- CVS Health (Springfield, IL)
- …other Windows based computer applications. * Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical ... Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU)...employee discount at all CVS stores. This is a remote role open to qualified candidates within the United… more
- Prime Therapeutics (Springfield, IL)
- …Technician - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... medical management staff and/or pharmacists. + Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected … more
- Prime Therapeutics (Springfield, IL)
- …Sr - 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
- Walgreens (Deerfield, IL)
- …which may include but not limited to rejections for plan limits, coverage termed or prior authorization . + Assists physicians in the prior authorization ... resources or over the phone. Confirms network status, reviews FDA guidelines, and prior authorization requirements to ensure payment of claims. + Resolves… more
- Prime Therapeutics (Springfield, IL)
- …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
- IQVIA (Chicago, IL)
- …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
- Adecco US, Inc. (Downers Grove, IL)
- …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
- Cardinal Health (Springfield, IL)
- …performing customer service, enrollment and reimbursement activities, benefit investigations for pharmacy benefit coverage, prior authorization assistance, ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more
- Humana (Springfield, IL)
- … pharmacy benefits manager (PBM) activities, including the establishment of prior authorization , clinical appropriateness of use; consultations and clinical ... the managed care industry + Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, UM, discharge planning… more
- Otsuka America Pharmaceutical Inc. (Chicago, IL)
- …product access, such as local market payor coverage, co-pay options, prior authorization requirements, formulary placement, and availability expectations. This ... within LTC facilities, such as administrators, directors of nursing, and pharmacy managers. These stakeholders directly influence purchasing and treatment decisions… more
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