- 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
- 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
- Merck (Raleigh, NC)
- …and/or education to HCP accounts on patient access, including benefit verification, prior authorization process, appeals process, and patient support programs in ... B, Medicaid, commercial) and related access processes, including benefit verification, prior authorization , and appeal processes * Expertise in pharmaceutical… more
- CVS Health (NC)
- …Insured Business + Collaborate with Utilization Management to develop and implement Prior Authorization Criteria specific to Aetna. **Cost of Care Initiatives** ... resource for the Health Plan for all issues/concerns that are pharmacy related. This is a remote role open to qualified candidates within the United States, with… more
- TEKsystems (Durham, NC)
- …plan types listed above using call‑guide prompts. Skills insurance verification, prior authorization , medical insurance, Customer service, Multi tasking, Call ... Role Summary Care Managers conduct high‑volume outbound calls to payors/ pharmacy benefit managers (PBMs) to determine whether commercially insured patients… more
- BrightSpring Health Services (Charlotte, NC)
- …proper authorization of payroll actions and Validates/organizes payroll checks prior to distribution + Inputs employee work schedules into workforce timekeeper ... homes for adults regardless of disability, behavioral/mental health support, in-home pharmacy solutions, telecare and remote support, supported employment and… more
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