• Ambulatory Medication Access Coordinator…

    Truman Medical Centers (Kansas City, MO)
    …with **medication reimbursement and billing processes** + Familiarity with **pharmacy benefit management (PBM), prior authorization platforms** , or EHR ... optimization** . You'll advocate for patients through complex benefit investigations, prior authorization support, and financial assistance programs-making a… more
    Truman Medical Centers (06/11/25)
    - Related Jobs

  • Senior Pharmacist

    Highmark Health (Phoenix, AZ)
    …Committee review. + Assist in the development and implementation of utilization management programs including but not limited to: prior authorization , ... account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and disease management initiatives.… more
    Highmark Health (06/26/25)
    - Related Jobs

  • Clinical Review Nurse

    Actalent (Dallas, TX)
    Clinical Review Nurse ( Utilization Management )100% Remote Job Description The role of the Utilization Management Nurse involves performing concurrent ... setting of care. Essential Skills + 2+ years of utilization management and utilization review... review expertise. + Experience in concurrent review and prior authorization . + Knowledge in managed care… more
    Actalent (08/08/25)
    - Related Jobs

  • Production Controller (Scheduling)

    Air National Guard Units (Reno, NV)
    …located in an ANG Flying Wing in the Plans, Scheduling, and Documentation/Engine Management Section of the Maintenance Operations Flight. The primary purpose of this ... is to perform preliminary planning and long term forecasting of utilization of aerospace vehicles, engines, and associated support equipment. Responsibilities 1.… more
    Air National Guard Units (08/07/25)
    - Related Jobs

  • Budget Analyst Title 32 Indefinte

    Army National Guard Units (Concord, NH)
    …this position is to serve as the analyst and consultant for the management and administration of budget programs within the directorate/division. Serves as key ... work requires knowledge and skill in the application of financial management , related laws, regulations, policies, acquisition, precedents, methods, and techniques… more
    Army National Guard Units (07/13/25)
    - Related Jobs

  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Omaha, NE)
    …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
    Molina Healthcare (07/17/25)
    - Related Jobs

  • Insurance Pre-Cert Coord at Infusion Services…

    Penn Medicine (Philadelphia, PA)
    …will ensure access to integrated health care; achieve clinically appropriate authorization to assure optimal reimbursement for the hospital for services provided. ... for pre-cert, patient payments, coverage limitation and determine necessary action prior to patient arrival. Assess information for appropriateness of setting and… more
    Penn Medicine (08/07/25)
    - Related Jobs

  • Vice President - Pharmacy

    GEHA (Lee's Summit, MO)
    …development and implementation of clinical pharmacy programs including prior authorization , adherence support, and medication therapy management . + Ensure ... Ratio (MLR), and ensuring integration of pharmacy strategy across population health, utilization management , and quality initiatives for all GEHA products and… more
    GEHA (06/13/25)
    - Related Jobs

  • Program Analyst (Title 32)

    Army National Guard Units (Springfield, IL)
    …plans, and estimates to determine cause and impact on missions. Assist management in interpretation and utilization of reports and information provided. ... military grade listed in the announcement. This is required prior to the effective date of placement. If you...Management Level Certified position IAW the National Defense Authorization Act (NDAA) 2012, Public Law 112-81, Subtitle F-Financial… more
    Army National Guard Units (08/02/25)
    - Related Jobs

  • Temporary- Managed Care Pharmacy Technician

    CDPHP (Albany, NY)
    …coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed pharmacist. ... The pharmacy tech will participate in an on-call/holiday rotation along with a utilization management pharmacist to support Plan members in after hour pharmacy… more
    CDPHP (07/29/25)
    - Related Jobs