- Prime Therapeutics (Raleigh, NC)
- …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
- Teva Pharmaceuticals (Raleigh, NC)
- …with Patient Support Service team with regards to education on Prior Authorization process at the HCP and local pharmacy level + Utilizes networks ... Associate Director of Specialty Pharmacy Operations - Remote Date: Jan 8, 2026 Location: Raleigh, United States, North Carolina, 07054 Company: Teva… more
- Cardinal Health (Raleigh, NC)
- …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 (Raleigh, NC)
- …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 (Raleigh, NC)
- …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 (Raleigh, NC)
- …**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 (Raleigh, NC)
- …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
- TEKsystems (Raleigh, NC)
- …health care, insurance, patient access, medical terminology, patient registration, prior authorization , inbound call, administrative support, customer service, ... Details insurance claim,call center,insurance verification,health care,insurance,patient access,medical terminology,patient registration, prior authorization ,inbound call,administrative support,customer service,medicare,medicaid Additional… more
- TEKsystems (Raleigh, NC)
- …and patient access. + Knowledge of medical terminology, patient registration, and prior authorization . + Strong empathy and soft skills. + Adherence ... Job Title: Pharmacy Patient Care CoordinatorJob Description Join our team...exceptional customer service and healthcare support. In this fully remote position, you will manage inbound and outbound calls,… more
- Humana (Raleigh, NC)
- …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