- CVS Health (MA)
- … Pharmacist with CVS Health. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians ... experience using clinical resources, eg, Micromedex, Lexicomp, Clinical Pharmacology * Prior authorization ... authorization pharmacy technicians and/or providers for clinical information. * Active pharmacist license that… more
- Prime Therapeutics (Boston, MA)
- …for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including ... processing and documenting of Utilization Management requests (ie formulary exceptions, prior authorization , step therapy, quantity limit exceptions) for… more
- Children's Hospital Boston (Boston, MA)
- 82359BRJob Posting Title: Prior Authorization Coord-Pharm TechDepartment:AnesthesiaAutoReqId:82359BRStatus:Full-TimeStandard Hours per Week:40 Job Posting ... of the PA process with the insurance companies, engaging clinical pharmacist and prescriber support as needed....denials and appeals when needed. + Coordinates and tracks prior authorization renewals, ensuring timely follow-up and… more
- Prime Therapeutics (Boston, MA)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 6 months dispensing or retail experience ... Technician - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Prime Therapeutics (Boston, MA)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience ... Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Beth Israel Lahey Health (Burlington, MA)
- … staff, pharmacy staff, and third party payers for issues regarding prior authorization approvals, ambulatory infusion reimbursement and Patient Assistance ... 2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic administered or… more
- Tufts Medicine (Melrose, MA)
- …Obtains treatment plans and patient demographics to begin insurance verification and authorization process. Works with clinical staff to obtain information ... or a role that focuses on support of daily business activities (eg, technical, clinical , non- clinical ) operating in a "hands on" environment. The majority of… more
- Beth Israel Lahey Health (Westwood, MA)
- …**Essential Responsibilities:** 1. Understands product and payer reimbursement landscape and prior authorization guidelines and processes. 2. Collects and ... reviews all data needed pharmacy and/or medical for prior authorization approvals. 3. Resolves insurance related...provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate. 5. Serves as the… more
- Beth Israel Lahey Health (Needham, MA)
- …support outpatient clinics, the Pharmacy Technician will complete and submit Prior Authorization /Tier Exceptions and Patient Assistance Foundation requests. ... medications, as needed, in accordance with departmental procedures. Receives requests for Prior Authorization from pharmacy or Tier Exception/PAF request from… more
- Highmark Health (Boston, MA)
- …claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network ... requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. +...and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as… more