- CVS Health (Des Moines, IA)
- …AND RESPONSIBILITIES: 1. Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design ... * Board Certified Oncology Pharmacist (BCOP) required * 2+ years clinical pharmacist experience, inclusive of prior authorization experience * Knowledge of… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- … in addition to being responsible for the daily Clinical Pharmacist operations and decision-making process related to coverage determinations , ... for all aspects of Formulary maintenance and management. The Clinical Pharmacist may also be required to...Therapeutics Committee Meeting + CMS Model Letter Reviews + Coverage Determinations and monitoring of optimal cost… more
- CVS Health (Austin, TX)
- …level agreements. - Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. ... And we do it all with heart, each and every day. Ready to take your Clinical Pharmacist skills to the next level with a Fortune 6 company? Check out… more
- MVP Health Care (Schenectady, NY)
- Professional, Clinical Pharmacist Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Tarrytown Office, 303 South Broadway, ... thinking and continuous improvement. To achieve this, we're looking for a **Professional, Clinical Pharmacist ** to join #TeamMVP. This is the opportunity for you… more
- US Tech Solutions (May, OK)
- …**Job Description:** + Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. ... Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and… more
- Sharp HealthCare (San Diego, CA)
- …**Preferred Qualifications** + 2 Years Pharmacy experience in a related clinical area. + Certified Pharmacy Technician (CPhT) - Pharmacy Technician Certification ... + Utilizes reliable transportation and possesses adequate personal insurance coverage . Demonstrates clean driving record in accordance with requirements of… more
- US Tech Solutions (May, OK)
- …required to initiate and/or resolve coverage requests. Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as ... clinical questions, escalations and judgement calls to the pharmacist team. The Rep I, Clinical Services...to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close… more
- US Tech Solutions (RI)
- …to initiate and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. ... clinical questions, escalations and judgement calls to the pharmacist team. + The Rep I, Clinical ...to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close… more
- Veterans Affairs, Veterans Health Administration (Cleveland, OH)
- …by the RN Case Manager. Assist additional teams with home visits and coverage during periods of absence. Collaborates with the HBPC Interdisciplinary Team which ... Occupational Therapist/Physical Therapist, Social Work, Dietitian, Speech Therapist, Psychologist, Pharmacist and Advanced Practice Provider. Collaborates with services internal… more