- Elevance Health (Las Vegas, NV)
- **Title** : Process Expert II **Location:** 5800 North Hampton Blvd, Norfolk, VA 23502 **HYBRID** - This role requires associates to be in-office 1 - 2 days per ... Occasional Evening Shift- 12:00-8:00PM EST (coverage rotates every 4-6 weeks) The ** Process Expert II** supports a single operations department by participating in… more
- CVS Health (Austin, TX)
- …the Prior Authorization team. - Collaborates with the technicians and prior authorization team members to process referrals, including answering clinical ... within the designated service level agreements. - Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria… more
- Cedars-Sinai (Beverly Hills, CA)
- …years in a row on the "Best Hospitals" Honor Roll. The Clinical Prior Authorization Pharmacist Specialist at Cedars-Sinai Medical Center will work in collaboration ... with the Prior Authorization Pharmacy Technician, Drug Use Policy, as well...payor update reviews, claim data analysis, assist with appeal process , review and incorporate payor clinical criteria into medication… more
- Elevance Health (San Antonio, TX)
- …impact:** Primary duties may include, but are not limited to: + Efficiently process and submit prior authorization requests for 340B specialty medications ... the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** TX-SAN ANTONIO, 4751 HAMILTON WOLF RD, STE… more
- US Tech Solutions (RI)
- …duties as assigned by the leadership team. + Work closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple ... and courteous phone assistance to all callers through the criteria based prior authorization process . + Maintains complete, timely and accurate documentation… more
- CVS Health (Tallahassee, FL)
- …approval & denial management processes. * Collaborate with the technicians and prior authorization team members to process referrals, including answering ... **Position Summary** This position is for a Clinical Pharmacist working in the Prior Authorization team. Candidate must hold active pharmacist licensure in the State… more
- University of Rochester (Rochester, NY)
- …Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910335 Ortho Prior Authorization Work Shift: UR - Day (United States of America) Range: UR ... data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and… more
- US Tech Solutions (May, OK)
- …other duties as assigned by the leadership team. Work closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple ... and courteous phone assistance to all callers through the criteria based prior authorization process . Maintains complete, timely and accurate documentation of… more
- US Tech Solutions (May, OK)
- …role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical ... from physicians or members regarding their pending, approved, or denied prior authorizations. **Responsibilities:** + Ensure accuracy of case setup and clinical… more
- CareOregon (Portland, OR)
- …Texas, Montana, or Wisconsin. Job Title Pharmacy Clinical Coordinator - ( Prior Authorization) - Contingent Exemption Status Exempt Department Pharmacy Manager Title ... medication authorization requests and providing oversight to the medication PA process ; and other pharmacy program activities as assigned. Essential Responsibilities… more