- CVS Health (MI)
- …all with heart, each and every day. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the ... Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical ... authorization pharmacy technicians and/or providers for clinical information. * Active pharmacist license that… more
- Prime Therapeutics (Lansing, MI)
- …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
- Molina Healthcare (Detroit, MI)
- …pharmacy/health plan providers, Molina staff and others as needed. * Performs prior authorization reviews of high-cost medications and deferred authorization ... subject matter expertise for pharmacy Medication Therapy Management (MTM) and clinical pharmacy services activities. Contributes to overarching pharmacy strategy for… more
- Molina Healthcare (MI)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction),… more
- Prime Therapeutics (Lansing, MI)
- …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 (Lansing, MI)
- …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
- Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
- …pharmacist to receive from the Community Care representative. Initiates the non-formulary/ prior authorization process with the Community Care provider and ... fax with Community Care Provider regarding initiated communications concerning non-formulary/ prior authorization medications, clarifications, or medication change… more
- Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
- …ePharmacy rejects and processes them to be dispensed. Sends rejects to Clinical Pharmacist for resolution when appropriate. Interacts with patients, providers, ... Summary The incumbent will assist the pharmacist in providing optimal care and timely service...receive appropriate medications in a timely manner Helps start prior authorization request for outside prescription plans.… more
- Humana (Lansing, MI)
- …Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization , formulary management and clinical programming ... of our caring community and help us put health first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing … more
- Highmark Health (Lansing, MI)
- …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