Lead Appeals Pharmacist - Prior Authorization
Judi Health, LLC
Judi Health in New York, NY is seeking a subject matter expert on prior authorization and appeals operations compliant with federal, state, and other regulatory standards across Commercial, Medicare Part B&D, and Medicaid. You will supervise appeal pharmacists and staff, develop workflow processes, provide ongoing training, and resolve escalated client issues while maintaining quality and productivity standards. #J-18808-Ljbffr Judi Health, LLC
- Oscar is hiring a Clinical Pharmacist Supervisor - Prior Authorization to join our Pharmacy Utilization Management team. This role oversees a team of pharmacists... ...clinical reviews for prior authorizations and appeals, driving operational excellence, and ensuring sound,...SuggestedRemote job
- Judi Health seeks an experienced subject matter expert in prior authorization and appeals, ensuring compliance with federal and state standards... ...business. You will oversee PA processes, supervision of appeal pharmacists, and staff scheduling, with a focus on performance,...Suggested
- Judi Health, LLC is seeking a licensed pharmacist leader to manage a team responsible for PA criteria, system configuration, and communications... ...mindset, strong clinical knowledge, and capability to lead high-performing teams in a dynamic environment, with hybrid work...Suggested
- ...Description Job Description Duties: Reviews Medical drug prior authorization and appeal requests for all LOBs then renders coverage... ...Skills: Required Skills & Experience: One (1) year of Pharmacist experience. Preferred Skills & Experience: Pharmacy...Suggested
$60 - $70 per hour
...actively recruiting several clinical Pharmacists to support a leading national health organization in... ...-making process for pharmacy drug authorizations and appeals . This fully remote opportunity allows... ...clinical determinations for prior authorization and appeal requests....SuggestedContract workTemporary workRemote workFlexible hoursShift workWeekend work$50 - $55 per hour
...prospective and/or retrospective drug utilization review and appeals per State and Federal regulations. Participates in the... ...guidelines, and work instructions. JOB RESPONSIBILITIES Provides prior authorization services for formulary drugs, develops programs to provide optimal...Contract workRemote workWork from home- ...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
- ...professional to work remotely, supporting clinic and hospital pharmacy locations. The role reviews prior authorizations, formulary exceptions, payer denials and appeals to facilitate timely access to prescribed therapies. It also performs clinical reviews of refill authorizations...Remote job
$84.8k - $99.38k
...Clinical Pharmacist## Clinical PharmacistApply: Remote-United States: Full time: Posted... ...responsible for conducting clinical reviews of prior authorization requests, ensuring that all... ...quality assurance activities* Support appeals, peer-to-peer reviews, and contribute...Full timeWork at officeRemote workHome office$135.79k - $178.23k
...Description Hi, we're Oscar. We're hiring a Clinical Pharmacist Supervisor - Prior Authorization to join our Pharmacy Utilization Management team. Oscar... ...clinical review for prior authorizations and appeals. This role will drive operational excellence, foster team...Full timeRemote workWork from homeHome office$119.36k - $205.9k
...End Date: 2026-11-02 Position Title: Prior Authorization Clinical Pharmacist Prior Authorization Clinical... ...conducting utilization review or an appeals consideration and cannot be located... ...advance our strategy but will also lead to personal and professional growth...Full timeContract workTemporary workWork experience placementWork at officeLocal areaDay shift1 day per week- CVS Health is seeking District Support Pharmacists to cover scheduling gaps and support pharmacy teams across stores in the district. You will work under the Pharmacy Manager and Rx District Leader to ensure safe dispensing, patient counseling, and immunization services...
- CVS Health Corporation seeks a District Support Pharmacist to cover scheduling gaps and support pharmacy teams across the district. You will work under the Pharmacy Manager and District Leader to ensure safe dispensing, patient care, and efficient store operations. The...
- CVS Health in New York, NY is seeking a part-time District Support Pharmacist to help cover district pharmacy staffing, support the Pharmacy Manager, and ensure safe dispensing across stores. You will travel within the district, immunize, counsel patients, oversee inventory...Part timeFlexible hoursWeekend work
- Natera is seeking a Supervisor, Prior Authorization to oversee the daily operations of the Prior Authorization teams, including domestic and... ...coordinate with Billing, Insurance Verification, Denials & Appeals, and other Revenue Cycle functions, driving process improvements...Remote job
- CVS Health seeks a District Support Pharmacist (DSP) to cover pharmacist scheduling gaps and support pharmacy teams across stores. You will ensure safe dispensing, patient counseling, and immunization services while acting as a proxy for the Pharmacy Manager during bench...Flexible hoursShift workWeekend work
- Fuze Health is seeking an Assistant Pharmacist in Charge to support Pharmacy Operations, supervising pharmacists and technicians and ensuring safe, compliant, efficient pharmaceutical operations. The role emphasizes patient safety, regulatory adherence, and cross-functional...
- RPh on the Go seeks an experienced Pharmacist for a full-time, 612 month contract in Brooklyn, NY, focusing on outpatient and specialty pharmacy operations within a large healthcare system. This role manages retail operations, 340B program compliance, and regulatory adherence...Full timeContract work
- ...responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. Monday-Friday 9:30am-6pm local... ...through Friday, 8:00 AM to 4:30 PM CT Call Center: They need a pharmacist license in their state of residence. The basic function of...Local areaMonday to Friday
- ...Remote Prior Authorization Pharmacist Location: Remote (U.S.-based) Type: Contract (with potential contract-to-hire, not guaranteed) Schedule: Full-time, 40 hours/week Pay Rate: $53.00/hour Openings: 25 Position Summary We’re hiring a Remote Prior Authorization Pharmacist...Hourly payFull timeContract workRemote work
- Oscar Health is seeking a Clinical Pharmacist Supervisor - Prior Authorization to lead the Pharmacy Utilization Management team. You will oversee clinical reviews for prior authorizations and appeals, drive operational excellence, and mentor pharmacists to maintain high...Remote job
$3,606 per week
...Job Description Immediate Pharmacist - Pharmacist openings in New York, NY ProMed Staffing Resources is seeking several Pharmacist... ..., NY Compensation: $3606.00 gross per week Work shift: 5x7 Prior Authorization Pharmacist Work Schedule: Full time Hours Per Week: 35 Days...Weekly payFull timeImmediate startShift work$60 per hour
...Review and make determinations on prior authorization requests for medications under the pharmacy benefit Conduct peer-to-peer calls with... ...Pharmacy (PharmD) 3+ years of experience working as a licensed pharmacist Willingness to obtain additional state licenses and/or...Contract workRemote workShift workWeekend work$51 - $57 per hour
...Job Title: Pharmacist Location: 100% Remote across USA Estimated Length of Assignment: 11+ Months (The dates provided are only an... ...responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. Experience 2 years of previous...Hourly payPermanent employmentApprenticeshipLocal areaRemote work$35 per hour
...Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors... ...with medications, prescriptions, pharmacy operations, and prior authorization workflows. Strong understanding of medication safety, drug...Contract workSummer workRemote work- ...This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. This individual must have excellent interpersonal skills. Will be responsible for: Reviewing and completing criteria based on prior authorization...
$122k - $128k
...care note/assessments for supportive clinical data needed for prior authorization approvals and development of care plan recommendations.... ...interventions including but are not limited to comprehensive pharmacist consultation, motivational interviewing/coaching, drug...Work at officeLocal areaRemote work- ...& Surgical is seeking an experienced Lead Pharmacy Technician to join our growing... ...common claim rejections. • Assist pharmacists with prescription workflow including... ...while helping patients navigate insurance coverage, prior authorizations, and pharmacy services....
$3,569 per week
Talent4Health is seeking a travel Pharmacist for a travel job in NYC, New York. Job Description & Requirements Talent4Health is... ...seeking a travel Pharmacist for a travel job in NYC, New York. Prior Authorization Pharmacist Specialty: Pharmacist Discipline: Allied...Full timeMonday to FridayShift work- MedOp Solutions is seeking a remote Pharmacist to perform complex prior authorization reviews and clinical determinations. You will collaborate with prescribers, conduct peer-to-peer calls, and contribute to quality audits while ensuring safe medication use. The role requires...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Lead Appeals Pharmacist - Prior Authorization. Be the first to apply!
- cardiology pharmacist New York, NY
- ambulatory pharmacist New York, NY
- remote prior authorization pharmacist New York, NY
- oncology pharmacist New York, NY
- research pharmacist New York, NY
- pharmacist night shift New York, NY
- pharmacist New York, NY
- production pharmacist New York, NY
- specialty pharmacist New York, NY
- immunization pharmacist New York, NY



