- Molina Healthcare (Augusta, GA)
- … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... patient outcomes, medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist , UM will be responsible for reviewing coverage… more
- Prime Therapeutics (Atlanta, GA)
- …evaluation for coverage determination requests for prior authorization (PA) or other utilization management ( UM ) programs, including quantity limits, step ... Pharmacist is responsible for the processing and documenting of Utilization Management requests (ie formulary exceptions, prior authorization, step therapy,… more
- CVS Health (Atlanta, GA)
- …Senior Manager in Medical Affairs and is responsible for clinical drug list, formulary, and utilization management ( UM ) analyses, with a focus on MHP. The ... environment + 2 to 3 years demonstrated experience in formulary development and pharmacy utilization management + Deep, broad knowledge of drug and disease state… more