Pharmacy Program Specialist II: Prior Authorization & PBM Coordination
340B Health
340B Health seeks a Pharmacy Program Specialist II to perform criteria-based reviews of pharmacy and medical benefit requests according to established guidelines. The specialist will ensure accuracy in processing prior authorizations while delivering exceptional customer service. Qualified candidates possess a Bachelor's degree in a healthcare field or business administration, along with registration as a pharmacy technician. Strong experience in healthcare plans and prior authorization processes is essential for success. #J-18808-Ljbffr
- ...Pharmacy Program Specialist II Community Health Choice, Inc. (Community) is a... ...guidelines, plan policies, and prior authorization protocols. The role... ...reporting, monitoring delegated PBM functions, and promoting... ...clinical reviewer PBM Coordination and Workflow Support...SuggestedWork experience placementWork at office
- Harris Health seeks a Pharmacy Program Specialist II in Houston, TX, to perform criteria-based reviews of pharmacy benefit... .... The role requires strong experience in prior authorization processes and coordination with PBM workflows. Additional competencies include problem...Suggested
- ...Health Choice in Houston, Texas, is seeking a Pharmacy Program Specialist II to perform criteria-based reviews for... ...and 3+ years' experience in a Health Plan or PBM. Key responsibilities include processing prior authorizations, supporting PBM workflows, and ensuring compliance...Suggested
$23 per hour
...Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Houston, TX| Full-Time | Starting at $23.00... ...Volunteer Day ~ Referral Incentive Program ~ Company Paid Life Insurance;... ...NCPDP claim rejection resolution, coordination of benefits, NDC medication...SuggestedFull timeTemporary workLocal areaRemote workRelocation package- ...Clinical Pharmacy Specialist Malignant Hematology Disease state areas... ...outcomes. Through innovative programs in patient care, research,... ..., and guidelines (ABN's, prior authorization requirements,... ...and residency leadership to coordinate individual learning experiences...SuggestedTraineeshipLocal areaDay shift
$21 per hour
...We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy... ...according to the coordination of benefits, resolve... ...payments are charged prior to shipment. Serves... ...or equivalent program from a 2 year program... ...claims resolution, PBM and Medical contracts...Full timeTemporary workWork experience placementRelocation packageFlexible hoursShift work$27 per hour
...Openings: 1 Senior Pharmacy Benefit Verification Specialist - Pharmacy located... ...coverage, assign coordination of benefits, run test... .../identify authorization requirements needed... ...copay card assistance programs. They will ensure... ...benefit verification, PBM and Medical...Temporary workWork experience placementFlexible hours- ...Clinical Programs Manager Pharmacist We're looking... ...be a key driver of the pharmacy based clinical... ...PDUR), and others. Coordinates and participates in performance... ...benefit manager (PBM) oversight. This includes... ...care physicians, 3,200 specialists, and 70 hospitals....Full timeWork at officeLocal areaShift work
- A healthcare organization in Houston, TX is seeking a full-time Pharmacy Prior Authorization Specialist. This position involves managing insurance pre-authorizations and appeals, supporting patients in accessing vital medications. Candidates should possess strong communication...Remote jobFull time
- ...At Houston Methodist, the Pharmacy IT Specialist is responsible for providing and coordinating pharmaceutical care to the patients of Houston... ...pharmacy informatics residency program Project management skills strongly preferred Prior experience in a lead role, or HM...
$55 per hour
...requests, including formulary exceptions, prior authorization, step therapy, and quantity limit... ...calls. Essential Skills Doctor of Pharmacy (PharmD) or Bachelor of Science in... ...subject to specific elections, plan, or program terms. If eligible, the benefits available...Remote jobContract workTemporary work- ...#HoustonHealthcare #ClinicalPharmacy #PharmD #BCOP Pharmacy Clinical Specialist - PharmD, BCOP Houston, TX | Level II Trauma Center A leading healthcare... ...initiatives, and support quality improvement programs. Key Responsibilities...
- ...Pharmacy Clinical Specialist This PRN position is required to work a minimum of eight shifts per... ...Qualifications ~ Graduate of education program approved by the credentialing body... ...of assuming responsibility for coordinating the activities of a major pharmacy service...ReliefShift workWeekend workWeekday work
$200k
...the Education Debt Reduction Program (EDRP), a student loan payment... ...an Accreditation Council for Pharmacy Education (ACPE) accredited... ...provisions in VA Handbook 5005, Part II, Chapter 3, section B,... ...Ability to solve problems, coordinate and organize responsibilities...Work at office- ...Education Debt Reduction Program (EDRP) - a student... ...Accreditation Council for Pharmacy Education (ACPE)... ...Handbook 5005 - Part II - Chapter 3 - section... ...Ability to solve problems - coordinate and organize... ...Incentives: Not Available EDRP Authorized: Former EDRP participants...Permanent employmentWork at officeRemote workRelocation packageMonday to Friday
- ...Pharmacy Clinical Specialist At Memorial Hermann, we pursue a common goal of delivering high quality... ..., and monitors clinical pharmacy programs to improve patient care with an additional... ...drug regimens. Works to develop, coordinate, and evaluate target drug programs,...
- ...Clinical Pharmacy Specialist We are searching for clinical pharmacy specialists. In the clinical... ...special medication needs and oversees coordination of activities to ensure proper... ...pharmacy personnel. Develops an educational program and a plan and incorporates into...Immediate startDay shift
- ...Hermann Hospital is Growing! The Children's Pharmacy team seeks a residency trained Clinical... ..., and monitors clinical pharmacy programs to improve patient care with an additional... ...and drug regimens. Works to develop, coordinate, and evaluate target drug programs, restricted...Shift work
$47.41 - $70.52 per hour
...manner. Verifies and checks medications prepared by other pharmacy personnel. Communicates drug information to patients... ...other health professionals. May serve as the Residency Program Director or Coordinator if applicable to their location. Performs duties in documented...$5,000 per month
...State}! Join our closed-door pharmacy team where you'll work in a... ...Employee wellness and discount programs *Benefits may vary by... ...drug utilization review (DUR) prior to dispensing (CMS CoPs) Controlled... ...errors Opioids (Schedule II) diversion + respiratory...Hourly payFull timeLocal areaRemote workRelocation packageFlexible hoursShift workNight shiftWeekend workDay shiftAfternoon shift- ...provide advice on healthy lifestyles. Background & Context: Pharmacy Appeals Department - Dept 247. Inclusive team culture,... ...through education. Contributes to team effort. Reviews prior authorization requests and evaluates approval criteria. Verifies member...Work at officeRemote work
- ...supervision of the Director of Pharmacy, processes the dispensing of... ...orders for accurate filling prior to delivering to the nursing... ...Assists in the communication and coordination of pharmacy activities with... ...Performance Improvement Program and medication use evaluations...Temporary workReliefFlexible hoursShift work
- JobRx, Inc. in Houston, Texas is seeking a Clinical Pharmacy Specialist in Inpatient Cardiology to ensure optimal medication use in patient... ...teams. Benefits include paid medical coverage, tuition assistance, and comprehensive wellness programs. #J-18808-Ljbffr JobRx, Inc.
$126.78k - $164.82k
Clinical Pharmacy Specialist-Oncology-PGY1-LBJ Hospital Clinical Pharmacy Specialist - Oncology - LBJ Hospital Pay: $126,776 to $164,819.20/... ...Term Disability insurance Life insurance Employee Assistance Program Tuition Reimbursement - Available after 6 months of...Full timeTemporary workTraineeshipFlexible hoursWeekend work$18 per hour
...A leading health information technology company is seeking a Bi-lingual Pharmacy Support Call Center Representative. This remote role involves providing customer support for an Opus Health program. Responsibilities include handling patient inquiries, documenting resolutions...Hourly payRemote workFlexible hours$57 - $59.5 per hour
...resource working from a computer, reviewing prior authorizations and receiving phone calls from prior authorization pharmacy technicians and/or healthcare providers to gather... ..., additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program...Hourly payWeekly payFull timeContract workTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayFlexible hoursShift workNight shift$56.8 - $81.09 per hour
...and experience with, state and federal insurance programs. Familiarity with appropriate local, state and federal pharmacy state were located. Ability to work effectively,... ...Experience in a managed care setting (HMO, MSO, PBM) is a plus. Certified to provide immunization is...Hourly payFull timeReliefLocal area$200k
...Education Debt Reduction Program (EDRP) - a student loan... ...Council for Pharmacy Education (ACPE) accredited... ...for Pharmacy Education. Prior to 2005 ACPE accredited... ...VA Handbook 5005, Part II, Chapter 3, Section B,... ...Graduate Pharmacist under the authority of 38 U.S.C. § 7405(c)(...Temporary workWork at officeRemote work- ...corrections, & Supporting central pharmacy operations. At Houston... ..., the Pharmacy Technician Specialist position serves in an... ...support of medication acquisition programs to ensure safe patient transitions... ...; and may lead the coordination of the day-to-day workflow and...Full timeInternship
- ...patients with special needs and oversees coordination of activities to ensure proper delivery... ...Requirements Required bachelor's degree Pharmacy and Ph.D. Pharm. D. degree Required... ...for children; and a global health program that is channeling care to children and...Local areaShift work
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