Remote Medicaid Prior Authorization Pharmacist
4004 Aetna Medicaid Administrators
- Remote job
CVS Health is seeking a Medicaid Prior Authorization Pharmacist to support our Medicaid PA program. This fully remote role is open to qualified candidates across the United States and requires active AZ and/or TX pharmacist licensure, with a plan to obtain the other license within 90 days. The position features a 40-hour work week (Mon–Fri with a 10:00 am–6:30 pm AZ time shift), eligibility for CVS Health bonuses, and a comprehensive benefits package including medical, dental, and vision #J-18808-Ljbffr 4004 Aetna Medicaid Administrators
$94.5k - $176k
...next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist Position... ...6 weeks and occasional holidays. This is a fully remote position open to qualified candidates within the United...Remote workHourly payFull timeTemporary workLocal areaShift work- ...reviewing and completing criteria based on prior authorization as per policy and procedure.... ...MUST HAVE Managed Care exp and Medicare/Medicaid knowledge. MUST HAVE 6 months of experienced... ...at least two years experience as a pharmacist in Managed care environment. Must...Remote work
- ...reviewing and completing criteria based on prior authorization as per policy and procedure.... ...MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. MUST HAVE 6 months of experienced... ...at least two years experience as a pharmacist in Managed care environment. Must...Remote workContract work
- ...Pharmacist, Prior Authorization (PA) & Appeals The pharmacist, prior authorization (PA) & appeals, is responsible for reviewing and evaluating... ...compliance with state and federal pharmacy laws, Medicare part D, Medicaid, and commercial benefit regulations. Accurately document...Remote work
$90.9k - $129.9k
...learning, and career development.SummaryAs a Pharmacist Advisor at Gainwell, you will provide... ...objectives.In addition to prior authorization activities, this role will support state... ...state and federal regulations, including Medicaid requirementsConduct clinical evaluations...Remote workFull timeFlexible hours- ...Job Description The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and... ...federal pharmacy laws, Medicare Part D, Medicaid, and commercial benefit regulations.... ...perform responsibilities and duties remotely with little to no supervision -...Remote work
$44 - $79 per hour
...Pharmacist At UnitedHealthcare, we're simplifying the health care experience, creating... ...~1+ years of experience of prior authorization case review & rendering PA decisions... ...experience PBM experience Experience in Medicaid, Commercial (private), and/or Medicare...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday$50 - $55 per hour
...of government programs including Medicare and Medicaid. JOB OVERVIEW Location: Work from home (100% remote) - refer list of states below. Duration: 6 months... ...instructions. JOB RESPONSIBILITIES Provides prior authorization services for formulary drugs, develops programs...Remote workContract workWork from home$107k - $127k
...Description Senior Managed Care Pharmacist – Formulary /... ...Work Arrangement: 100% Remote / Work from Home... ...Commercial, Medicare, Medicaid, and Exchange portfolios... ...Communications Lifecycle: Author and revise multi-channel... ...utilization management (Prior Authorization, Step Therapy...Remote workPermanent employmentFull timeContract workWork from homeMonday to FridayShift work$23 per hour
...Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Salt Lake... ...is a full-time position. Remote work if licensed in State of... ...Collaborate with physicians, pharmacists, and other departments.... ...insurance claims, Medicare, Medicaid, and commercial insurance,...Remote workFull timeTemporary workRelocation package$113.7k - $162.4k
...Preferred Drug List (PDL) Pharmacist supports the clinical, operational... ...financial PDL needs of the Medicaid Fee-for-Service line of... ...; developing PDL-related prior authorization criteria; identifying needed... ...~ This position is remote ~0-10% of travel. ~ Supports...Remote workFull timeWork at officeFlexible hours$60 - $70 per hour
...Remote MTM Pharmacist This MTM Pharmacist role focuses on defining and developing standard... ...design, improve quality of care for Medicaid and Medicare populations, and ensure... ...performance. Monitor and review prior authorization requests to ensure appropriate medication...Remote jobContract workTemporary work$40.87 - $80.43 per hour
...Pharmacist At UnitedHealthcare, we're simplifying the health... ...enjoy the flexibility to work remotely* from anywhere within the U... ...Experience in Medicaid, Commercial (private), and/... ...in Coverage Determinations (prior authorization) or member appeals Pharmacy...Remote jobHourly payWork experience placement$60 - $70 per hour
...Remote Mtm Pharmacist This MTM Pharmacist role focuses on defining and developing standard... ...design, improve quality of care for Medicaid and Medicare populations, and ensure... ...performance. Monitor and review prior authorization requests to ensure appropriate medication...Remote jobContract workTemporary work- ...Summary: Work Mode: 100% Remote in USA Shift: 10am – 6:3... ...to be initiated Monitor prior authorization requests Provide clinical... ...designed to impact DUR for both Medicaid and Medicare Develop,... ...: Required: Current states pharmacist license Minimum 1 year...Remote workShift workWeekend work
$120k - $125k
...Overview The Clinical Care Pharmacist plays a vital role in ensuring... ...responsible for reviewing prior authorization requests, supporting... ...Location & Schedule Location: Remote Shifts 7a-4p EST 9a-6p EST... ...Commercial, Exchange, Medicare, and Medicaid plans. Accurately document...Remote jobFull timeContract workShift workWeekend work- ...Position Title: Clinical Pharmacist 1 Work Location: Remote Assignment Duration: 3 Months Work... ...the Role * Reviews a completed prior authorization request received from the... ...care, understanding of Medicare/Medicaid law Disqualifiers: n/a Performance...Remote workWork at office
$44 - $79 per hour
...Pharmacist PA/Appeals - Remote in Vermont & Maine Optum is a global organization that delivers care... .... Growing together. As a Prior Authorization Pharmacist, you will support clinical... ...Knowledge of Medicare Part D, commercial, Medicaid, exchange, or client-specific...Remote jobHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to FridayFlexible hoursShift work$75 per hour
...Jack Dorsey . Position: Pharmacy Prior Authorization & Specialty-Medication Access Specialist... ...Compensation: $75/hour Location: Remote Role Responsibilities Process and... ...commercial, Medicare Part D , and Medicaid payers. Review clinical documentation...Remote workContract workSummer work- Gainwell Technologies is hiring a Pharmacy Prior Authorization Call Center Representative (Remote CT) to support the Connecticut Medicaid account in a fast-paced, high-volume environment. You will handle pharmacy claims and prior authorization inquiries, resolving issues...Remote jobRotating shift
- ...Clinical Pharmacist UNITAS provides clinical staffing and consulting solutions, including... ...Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions) for... ...Positions are available in Medicare, Medicaid, and Commercial lines of business....Remote jobPermanent employmentContract workLocal area
$89.9k - $160.6k
...Join to apply for the Clinical Pharmacist Utilization Management - Remote PST role at Optum . Optum is... ...evaluating medication utilization and prior authorization requests for specialty oncology... ...~ Proven knowledge of Medicare, Medicaid, and commercial payor guidelines...Remote workMinimum wageFull timeWork experience placementLocal areaMonday to Friday- ...Clinical Pharmacy Specialist to support the Prior Authorization Team within the Pharmacy Services... ...in PA. Registration as a registered pharmacist (RPh), in the Commonwealth of Pennsylvania... ...(DHS), Centers for Medicare & Medicaid Services (CMS), Pennsylvania Insurance...Remote jobFull timeWork from homeHome officeWork visa
- ...Staff Pharmacist – Independent Pharmacy & Primary Care Services Benson, NC | Full-Time... ...medication affordability programs and prior authorization support. Promote medication... ...Chronic Care Management (CCM) Remote Patient Monitoring (RPM) Medication...Remote workFull timeTemporary workWork at officeMonday to Friday
- ...Facilitate medication access by assisting with prior authorizations, drug therapy appeals, financial... ...medication needs or,Clinical Pharmacist hospital practice experience (2 years)... ...for monthly or weekly onsite attendance.Remote TypeHybridWork Location31 North AvenueScheduled...Remote workFull timeImmediate startFlexible hours2 days per week1 day per week
- ...Pharmacist needed for Remote / Work From Home Position! Multiple openings with aSeptember Start Dates! Pay Rate: 53.00 per hour depending... ...:30am-8pm CST Job Description: Evaluate and review all prior authorization requests and render coverage determinations based on clinical...Remote workHourly payFull timeWork at officeWork from homeHome officeMonday to Friday
$53 - $57 per hour
...Role:Clinical Pharmacist Advisor (Medicare) Location:Remote (Work From Home) — anywhere in the U.S.(must hold an active pharmacist license in your... ...Preferred Skills Experience inPBM / Medicare Part D / prior authorization / coverage determinations Strong documentation and...Remote workWork from homeMonday to FridayShift work$135k
...Pharmacist In Charge (Specialty) - Baton Rouge, LA House Rx is on a mission to make... ...counseling, therapeutic substitution, and prior authorization reviews Be the workflow expert in... ...ideas—no matter how radical. We are a remote-first company, however some pharmacy...Remote workFull timeWork from home- A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy... ...will be responsible for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in...Remote work
- ...It is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases...Remote work
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