Remote Pharmacy Prior Authorization Utilization Specialist
Alpha Business Solutions
- Remote job
Horizon Blue Cross Blue Shield in Newark, NJ is seeking a Pharmacy Specialist to receive verbal and written prior authorization requests and support Pharmacy Services activities including claim utilization analysis, plan design, ad-hoc reporting, and special projects. The role requires at least two years in third-party prescription program claim adjudication and as a Pharmacy Utilization Management Specialist, plus customer service experience. #J-18808-Ljbffr Alpha Business Solutions
- ...detail and a strong background in prior authorizations? We are seeking a highly... ...detail-oriented Prior Authorization Specialist to join our national Utilization Management team. In this role,... ...Position Type: Full-Time | 100% Remote Schedule: Monday – Friday, 8:...Remote workFull timeLive inWork from homeMonday to Friday
- ...Managing insurance authorizations for mental health and substance use treatment... ...full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations, and support... ...criteria while working remotely. Key responsibilities Verify...Remote workFull time
$24 - $26 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$2... ...Specialist to manage insurance authorizations for adolescent and adult mental... ...requirements. Complete prior authorizations, pre-certifications...Remote workFull timeMonday to Friday- Centene Corporation is seeking a dedicated professional to support the prior authorization request process and assist the utilization management team in Florida. The role ensures timely authorization determinations, documents medical information, and verifies insurance...Remote jobHourly payFull time
- About this job Job Title: Prior Authorization Specialist Location: Fully remote Duration: 12 months contract Prior Authorization... ...in-bound calls from providers, pharmacies, members, etc providing... ...where needed. Responsibilities: Utilizing multiple software systems to complete...Remote workContract work
- ...in health system pharmacy—designing pharmacy... ...ABOUT THE ROLE (Remote, work from home)... ...Medication Access Specialist plays a vital role... ...medication authorizations, managing insurance... ...documentation for prior authorization submissions... .... Proficient in utilizing CoverMyMeds® for...Remote workFull timeWork at officeWork from home
- ...nation's leading pharmacy care management companies... ...50 states. PAC Specialists in our Patient... .... This is a remote-based environment... ...speed and accuracy. Utilizing sound drug... ...receive prescription authorizations, clarifications... ...auditing duties such as prior authorizations,...Remote workFull timeTemporary workWork at officeLocal areaFlexible hours
- ...A-Line Staffing Solutions is hiring licensed pharmacists for Remote Prior Authorization roles. These full-time, 40-hour/week positions are work-from-home opportunities with November start dates and various scheduling options to fit availability. Ideal candidates hold...Remote workFull timeWork from home
- ...staffing firm is seeking a Pharmacy Technician to support retail pharmacy operations remotely. This role involves processing... ...prescriptions, performing prior authorization reviews, and coordinating care... ...ideally with experience in utilization review. A strong knowledge of...Remote work
- ...Actalent is actively screening for multiple remote Pharmacists to join a leading pharmacy benefits optimizer based out of Birmingham, AL. The Clinical Pharmacist reviews prior authorization and appeals, collaborates with prescribers and pharmacies, and ensures regulatory...Remote work
$53 per hour
...A-Line Staffing Solutions is seeking a Pharmacist – Remote (Prior Authorization). The role pays $53 per hour and offers full-time, temporary-to-permanent employment. Responsibilities include reviewing prior authorization requests, ensuring regulatory compliance, and maintaining...Remote workHourly payPermanent employmentFull timeTemporary work- ...Job Description Job Description Utilities Specialist I - Hybrid - 3 days on site, 2 days WFH Full time; Non-Exempt; 40 hours/week;... ...a stationary position and/or move about the organization or remote office. The employee is frequently required to stand or walk...Remote workFull timeTemporary workWork at officeWork from homeFlexible hours
- ...LanceSoft is seeking a Pharmacist with PBM or Prior Authorization experience for a remote, full-time role. You will review and complete criteria for prior... ...B.Pharm, an active license, and at least two years of pharmacy experience. Strong computer, organizational, and...Remote workFull time
- ...Description Subject Matter Expert (SME) - Energized Line Maintenance & Utility Safety Assessment Overview We are seeking an... ...Date: October-November timeframe Work Arrangement: Primarily remote with a hybrid component Travel: Required for onsite field...Remote work
- ...seeking an Acute Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying... ...submission, and follow up of payer authorization requests. Responsibilities... ..., follow-up, and secure prior authorization, pre-determination...Remote workFull timeContract workImmediate startMonday to Friday
- ...Job Description Job Description Utility Vegetation Management Specialist Who are we? We’re dedicated to the growth of our employees. We... ...vehicle operation and foot patrol of utility power lines; remote locations as well as urban, city environment; physical...Remote workFull time
- Elevance Health's BioPlus Specialty Pharmacy is hiring an Authorization Representative I to handle re-authorizations... ...weekly with flexible, supportive remote work, within a hybrid framework. The... ...diploma/GED and at least 1 year of prior authorization experience, with...Remote workWork at officeFlexible hours
$40 per hour
Job Title: Intake Authorization Specialist Job Type: Full-time Pay: up to $40... ...home infusion and specialty pharmacy services. We are accredited... ...Qualifications Required: Prior experience in home infusion... ...holidays. Opportunity for remote work based on qualifications...Remote workHourly payFull time$19 - $20 per hour
## Authorization Management SpecialistApply: In Person: Amber Specialty Pharmacy, S 152nd St, Omaha, NE: Full time: Posted... ...Management Specialist**Department:** Operations... ...appeal summaries and prior authorizations, correspondence... ..., meetings, and remote events* Constantly operates...Remote workHourly payFull timeWork experience placementWork at officeLocal areaMonday to Friday- ...reduce the costs of pharmacy benefits for its members... ...of initial prior authorization (PA) requests. Operating... ...the Pharmacy Support Specialist (PSS) team. Essential... ...clinical guidelines, and utilization management workflows.... ...case reviews. Remote Productivity: Self-motivated...Remote work
- ...this position. Reporting to the Manager of Clinical Pharmacy, the Clinical Utilization Management Pharmacist is primarily responsible for... ...and duties. Other duties may be assigned. 1. Make prior authorization and step therapy determinations for drug utilization...Remote workWork at officeShift work
- ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and appeals...Remote work
- ...Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on... ...obtaining and maintaining insurance authorizations, communicating with managed... .... The ideal candidate has prior utilization review or behavioral...Remote workPart timeWeekend work
$17 per hour
...Prior Authorization Specialist Location: Remote (Work from Home) Employment Type: Full-Time Pay rate: $17/hour Work Schedule: This is a full-time role... ...administrative and clerical support tasks as needed Utilize multiple systems and applications efficiently in a...Remote workFull timeWork from homeMonday to FridayFlexible hoursShift work- Cambia Health Solutions seeks an UM IP Clinical Specialist to review inpatient utilization requests, research information, and coordinate with clinicians to support efficient reviews. The role emphasizes accuracy, timeliness, and adherence to regulatory standards. Work...Remote jobWork from home
$22 - $26 per hour
...clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. Shift... ...requests accurately and in a timely manner, utilizing electronic submission platforms and following established...Remote workMonday to FridayShift work- ...Utilization Specialist Part time 20 hours a week then will go to a Full Time Opportunity Location: Central Florida; must be willing to travel to Orlando or Villages from time to time (remote, but available for onsite meetings) Key Responsibilities Review any new...Remote workFull timePart time
- ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday Overview... ...necessary, appropriately authorized, and compliant with payer, state,...Remote workFull timeMonday to FridayFlexible hours
- ...To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to ensure compliance with...Remote workFull time
$26 per hour
...Responsibilities The Authorization Representative will need to... ...of authorization status. Prior Authorization and Eligibility... ...Assist with payer audits and utilization management reviews by providing... ...this role is: 26 - 26 USD per hour (Remote (United States))Remote workHourly pay
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