- Prime Therapeutics (Austin, TX)
- …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
- Actalent (Houston, TX)
- …to review Medicaid members' Utilization Management requests, including formulary exceptions, prior authorization , step therapy, and quantity limit exceptions. ... Fully Remote Pharmacist Excellent Career Growth | Offers Benefits...clinical judgment to determine the approval or denial of prior authorizations based on client-specific criteria. + Communicate regularly… more
- Cognizant (Austin, TX)
- …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
- US Tech Solutions (TX)
- **Job Title:** ** Prior Authorization Pharmacist** **Location: Remote ** **Duration: 6+ months contract** **Job Description:** + Responsible for reviewing and ... authorization as per policy and procedure. **Experience:** + Prior authorization experience required. + Previous pharmacy experience in retail or hospital… more
- Merck (Austin, TX)
- …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 (TX)
- …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
- J&J Family of Companies (San Antonio, TX)
- …billing. + Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to ... + Immunology disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access… more
- Adecco US, Inc. (Irving, TX)
- …+ **Benefit & Access Education (25%)** - Educate providers on benefit verification, prior authorization , payer trends, and support center services. Document and ... **Job Title:** Field Reimbursement Manager (FRM) - Remote with Territory Travel **Location:** Remote - Must reside in Houston, TX or surrounding areas **Pay… more
- BrightSpring Health Services (San Antonio, TX)
- …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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