Remote Pharmacy Utilization & Prior Authorization Specialist
Point32Health, Inc.
Point32Health is seeking a Pharmacy Utilization Management Specialist to set up and process drug prior authorization cases across PA workflows. You will review cases for regulatory compliance and document notes for pharmacists or medical directors.
Requires a CPhT certification, high school diploma and 2+ years of pharmacy experience; experience in managed care or RxClaims/PAHub is preferred. Remote role, standard hours with potential for extended schedules.
#J-18808-Ljbffr- ...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
$24 - $26 per hour
...Utilization Review Specialist - Behavioral Health (Remote) PHP/IOP | Full-Time | Monday-Friday, 9 AM-5 PM ET | $24-$26/... ...Specialist to manage insurance authorizations for adolescent and adult mental... ...coverage requirements. Complete prior authorizations, pre-certifications...Remote workFull timeMonday to Friday- ...Role Summary: The Authorization Specialist role is responsible... ...Information System, Pharmacy Information System, Entire... ...frequency and prior testing requirements.... ...skills. Ability to utilize websites, portal and... ...on the needs of the organization. #LI-REMOTE...Remote workFull timeWork at office
$19 - $20 per hour
## Grant Specialist, Authorization ManagementApply: In Person: Amber Specialty Pharmacy, S 152nd St, Omaha, NE: Full time... ...General Function:**The Prior authorization team is... ...and co-pay cards are utilized, and exploring... ...conferences, meetings, and remote events.* Constantly...Remote workHourly payFull timeWork experience placementWork at officeLocal areaMonday to Friday- ...behavioral health guidelines. The role involves prior authorization reviews, data analysis to improve utilization, and collaboration with BH providers. Time-zone residency... ...in PST, MST, or CST is required, with flexible remote/hybrid options. #J-18808-Ljbffr Centene...Remote workFlexible hours
- 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
- ...Medication Access Specialist We are... ...pharmacydesigning pharmacy footprints that meet... ...providing integrated remote support to... ...handling medication authorizations, managing insurance... ...documentation for prior authorization submissions... .... Proficient in utilizing CoverMyMeds for...Remote workFull timeWork at office
- 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
$20 per hour
...- Putting People First in Pharmacy - Navitus was founded as an... ...g. M-F 8am to 5pm) Varies Remote Work Notification... ...Health Solutions is seeking a Specialist I, Prior Authorization to join our team! The Specialist... ...requirements Utilize work down time for personal...Remote workFlexible hours$18.92 - $23.46 per hour
...Vital Care is the premier pharmacy franchise business... ...Perform duties to initiate authorizations, focusing on accuracy,... ...This position is 100% remote. Duties/... ...to complete and submit prior authorizations timely... ...knowledge and skill in utilizing the MS Office suite of...Remote workFull timeContract workTemporary workLocal areaImmediate startFlexible 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
$20 per hour
...NTT DATA Services is seeking Pharmacy Technicians/CSR for a remote 1-year contract opportunity. Training is 6 weeks, M-F CST. Two shift options... ...pay at $20/hour. Responsibilities include inbound Prior Authorization support, documentation, and escalation to pharmacists...Remote workContract workShift work$40k - $46k
...Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy. This remote position requires expertise in specialty infusion prior authorization and customer service skills. Candidates must have at least 2 years of relevant experience...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$40 per hour
...Job Title: Intake Authorization Specialist Job Type: Full-time Pay: up... ...home infusion and specialty pharmacy services. We are accredited... ...Required: Prior experience in home infusion... ...holidays. Opportunity for remote work based on qualifications...Remote workHourly payFull time- ...Actalent is seeking a Remote Pharmacy Technician to support Medicare and Medicaid patients by processing prior authorizations in a fully remote role. You will intake requests, perform technical reviews, and determine coverage based on established criteria, SOPs, and medical...Remote workContract work
$53 per hour
...A-Line Staffing is seeking a Pharmacist for a remote Prior Authorization role. The position is full-time, temporary-to-permanent, with hourly compensation of $53.00. The work delivers PBM-focused responsibilities from a home office while adhering to regulatory standards...Remote workHourly payPermanent employmentFull timeTemporary workHome office$22 per hour
About the job JX22004069329 - Pharmacy Technician I - Remote 2 Years Contract (3 Months) Pay Rate... ...Responsibilities: The Tech I Prior Auth takes in-bound calls from providers... ...callers through the criteria based prior authorization process. Maintains complete, timely...Remote workHourly payContract workWork at office- ...intelligent data management, pharmacy optimization, and value-... ...Job Overview The Intake Specialist is responsible for... ...required elements are obtained prior to benefits investigation and authorization Patient & Provider... ...Paid Time Off. Location Remote with limited travel to client...Remote workWork at office
- ...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
- ...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
- ...A-Line Staffing Solutions is seeking a remote Pharmacist to perform prior authorization reviews and determine coverage using plan criteria. You will collaborate with the team to gather clinical data, communicate decisions to providers, and ensure PHI/privacy standards...Remote work
- ...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
$20.31 per hour
...changes everything. We are looking for a Prior Authorization Specialist to join our team! In this role you... ...between 7 am -5 pm, 8-hour shifts Remote eligible after training in‑person in... ...health services; vision centers; pharmacies; and air and ground ambulance services...Remote workFull timeWork from homeMonday to FridayShift work- The Cigna Group is seeking a Pharmacy Prior Authorization Senior Representative to obtain initial and renewal authorizations for Specialty Pharmacy and/or Specialty Infusion services. You will collaborate with clinicians to assemble documentation per formulary guidelines...Remote job
- ...Pharmacist to join a healthcare and pharmacy benefits organization in a fully remote capacity. This contract... ...professional with experience supporting utilization management, medication coverage... ...include evaluating prior authorizations, analyzing utilization data, documenting...Remote workContract work
$20 - $21.96 per hour
...Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health... ...5pm) 6am CST to 7pm, CDT Remote Work Notification ATTENTION... ...we are adding an Intake Specialist to our team! Under direction... ...insurance companies in triaging prior authorizations for patients of the...Remote workFlexible hoursShift work- ...Pharmacy Benefits Management Solution MedImpact Healthcare... ...The Formulary Administration Specialist I participates in the design... ..., Drug Information and Prior Authorization experience preferred; Familiarity... ...location (or from a remote location with management approval...Remote workWork at officeMonday to FridayNight shiftWeekend work
- ...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
- ...Supporting the processing of commercial pharmacy benefit prior authorizations and appeals, the full-time Licensed Practical Nurse (LPN) Prior Authorization Specialist will work remotely to review requests, document case information, communicate referral statuses, and provide...Remote workFull timeWork at office
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