- Veterans Affairs, Veterans Health Administration (Saginaw, MI)
- Summary The clinical pharmacist is a licensed professional with knowledge and proficiency in pharmacy practice including pharmaceutics, pharmacokinetics, ... pharmacodynamics and pharmacotherapeutics. The incumbent is responsible for adjudicating Prior Authorization Drug Requests (PADRs) in an effective and efficient… 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 2 years dispensing or retail experience ... Pharmacy Technician SR. **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Prime Therapeutics (Lansing, MI)
- …functions, DUR committees and responsibilities. + Supports elevated customer service and prior authorization inquiries specific to assigned accounts. + Manages ... our passion and drives every decision we make. **Job Posting Title** Clinical Account Manager - Remote **Job Description** Innovative business clinician accountable… more
- Prime Therapeutics (Lansing, MI)
- …services that meet clinical review criteria. Refers all cases not meeting clinical criteria to pharmacist clinical reviewer. + Practices and maintains ... outreach and review of medical records to audit authenticity of provider response during Prior Authorization and reporting results to client. + Assists with the… 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
- Intermountain Health (Lansing, MI)
- …pharmacists in appropriate language. Develops protocols for the use of drugs requiring prior - authorization . Responds to clinical inquiries in a professional ... cost-effective quality pharmacy benefits to members. Responsible for providing clinical pharmaceutical support through physician/ pharmacist /member education and… more
- University of Michigan (Ann Arbor, MI)
- …interaction, collaboration with an interdisciplinary team, insurance claim adjudication, prior authorization facilitation, and prescription processing in a ... and Meds to Beds duties include: + Collaborate with the transplant clinical team and specialty patient financial counselors to identify upcoming discharges and… more