Pharmacist - Prior Authorizations
Managed Staffing, Inc.
Looking for Pharmacist who have Remote Prior Authorization Experience & Must be licensed in the state of North Carolina. (Can reside in any state.) This position is for a Clinical Pharmacist working in the Prior Authorization team. This Pharmacist will: Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians, and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols. One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed‑upon approval & denial management processes. #J-18808-Ljbffr Managed Staffing, Inc.
$60 - $70 per hour
...is actively recruiting several clinical Pharmacists to support a leading national health... ...decision-making process for pharmacy drug authorizations and appeals . This fully remote... ...and render clinical determinations for prior authorization and appeal requests. Conduct...SuggestedContract workTemporary workRemote workFlexible hoursShift workWeekend work- ...Direct message the job poster from Managed Staffing, Inc. Looking for Pharmacist with 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical...SuggestedContract workRemote workWork from home
$53 per hour
...Remote Clinical Pharmacist – Prior Authorizations Pay: $53.00 per hour Job Type: Remote Contract Opportunity Schedule: Flexible 8-hour shifts between 7:00 AM – 10:00 PM CST Training Schedule: Monday-Friday, 8:00 AM – 4:30 PM CST for approximately 6 weeks Location: Fully...SuggestedHourly payContract workRemote workMonday to FridayFlexible hoursShift workWeekend work- ...Judi Health seeks an experienced subject matter expert in prior authorization and appeals, ensuring compliance with federal and state standards... .... You will oversee PA processes, supervision of appeal pharmacists, and staff scheduling, with a focus on performance,...Suggested
- ...Looking for Pharmacist who have Remote Prior Authorization Experience & Must be licensed in the state of North Carolina. (Can reside in any state.) This position is for a Clinical Pharmacist working in the Prior Authorization team. This Pharmacist will: ~ Evaluate...SuggestedRemote work
$120k - $125k
...Position Overview The Clinical Care Pharmacist plays a vital role in ensuring safe, effective, and appropriate medication use. This position is responsible for reviewing prior authorization requests, supporting clinical programs, and providing expert guidance to members...Full timeContract workRemote workShift workWeekend work$50 - $55 per hour
...and facility standard operating procedures, policies, guidelines, and work instructions. JOB RESPONSIBILITIES Provides prior authorization services for formulary drugs, develops programs to provide optimal pharmacy care to patients, participates in drug utilization...Contract workRemote workWork from home- ...About the role The Staff Pharmacist manages and maintains workflow efficiency. Additionally, the Staff Pharmacist dispenses prescription... ...utilization reviews (DUR's) and document interventions. Prior authorization management working specifically with the pre-approval...Relief
- ...New York, NY Contract Job Summary: The clinical pharmacist 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...Contract workWork experience placement
$5,000 per month
...improving overall quality of life at end-of-life. Consultative Pharmacists work collaboratively with nurses and caregivers to provide... ...and therapeutic substitution, formulary management and prior authorization procedures Demonstrates understanding, competency and adherence...Work experience placementRemote workHome office- ...Clinical Pharmacist The clinical pharmacist 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...Work experience placement
- ...An established industry player is seeking a dedicated Pharmacist to join their remote team. This role involves evaluating prior authorization requests, collaborating with healthcare professionals, and ensuring timely communication of coverage determinations. The ideal...Remote workWork from home
$92.88k - $178.2k
...decision tree oversight. Review and maintain UM criteria (e.g., prior authorization (PA) and step therapy) for clinical appropriateness and... ...team on vendor configuration for UM setup. Partner with pharmacist Formulary, UM, and analytics teams to select annual formulary...$100k - $120k
...Description Job description Pharmko Staff Pharmacist Job Description Description of Job... ...before dispensing. Assures presence of authorization to dispense. Manages the use,... ...become proficient based on training § Prior authorizations, eligibilities, precise...Full timeWork from homeMonday to FridayWeekend work$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...Local areaRemote work- MetroPlus Health in New York is seeking a Prior Authorization Review Technician to input, review, and notify on prior authorization requests within the pharmacy workflow. You will handle overrides in the adjudication system, respond to member inquiries, and support quality...Day shift
- MetroPlusHealth is hiring a Prior Authorization Review Technician in New York, NY. You will input, review, and notify on prior authorization requests within the Pharmacy Adjudication system, and handle member inquiries while supporting pharmacy operations. The role requires...
$120k - $125k
A healthcare company is seeking a Clinical Care Pharmacist to excel in safe medication use, review prior authorizations, and support clinical programs. This remote role requires a PharmD degree and 2 years of pharmacy practice experience, alongside strong communication...Remote job- VYTLOne is seeking a Prior Authorization Specialist for TMH Specialty Pharmacy to verify insurance eligibility and obtain benefits before medication delivery. You will communicate with payers, clinical partners, and patients to facilitate authorization, maintain clear records...Remote job
- ...Overview We are seeking a dedicated and detail-oriented Staff Pharmacist to join our growing independent pharmacy. The ideal... ...service and operational efficiency. Able to assist DR'S with prior authorizations Document and resolve DUR alerts through prescriber...
- Avenue 360 Health and Wellness in Georgia seeks a Staff Pharmacist to manage workflow, dispense medications, and deliver superior... ...Responsibilities include intake, verification, DUR interventions, prior authorization, and coordination with physicians while maintaining...
$135.79k - $178.23k
...Job Description Job Description Hi, we're Oscar. We're hiring a Clinical Pharmacist Supervisor - Prior Authorization to join our Pharmacy Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a...Full timeRemote workWork from homeHome office$120k - $150k
...Position Background Capital Rx is seeking a self-driven pharmacist with operating and leadership experience in utilization management... ...and servicing new and existing clients of JUDI's Prior Authorization Tool. This person will be expected maintain an in-depth understanding...Work at officeLocal areaRemote workShift work- ...responsible for coordinating with clients, pharmacists, and internal teams to ensure that all... ..., approved, and properly attributed prior to release Report / Case Review Review... ...client-specific workflows, including prior authorization, appeals, and exception processes...Temporary workWork at officeRemote workWork from home
- Mercor, on behalf of a leading AI research lab, seeks experienced US pharmacists to enhance AI-powered prior authorization workflows by answering medication-related questions and reviewing AI-generated responses for clinical accuracy and safety. You will annotate, provide...
- ...- UVM Medical Center is seeking an experienced ambulatory pharmacist clinician to optimize drug use in high-risk populations and... ...development, and supporting pharmacy operations including prior authorization and medication therapy outcomes. #J-18808-Ljbffr UVM Health...
- ...P osition Summary The Pharmacy Technician will assist pharmacists with prescription processing, insurance coordination, medication... ...preferred ~ Experience with insurance processing, prior authorizations, and pharmacy claims is a plus ~ Strong attention to detail...
$3,697 per week
...Pharmacist Location: New York, NY Agency: Seven Healthcare Pay: $3,697 per week Shift Information: Nights - 5 days x 7 hours Start Date: ASAP About the Position Location: New York, NY Type: Travel Schedule: 5x7 Nights Time: 14 Weeks...Weekly payFull timeImmediate startFlexible hoursShift workNight shift- ...organizational skills, exceptional customer service skills, and prior experience working in a fast-paced environment.... ...multitask and shift priorities, as needed Ability to process prior authorizations independently Sterile and non sterile compounding is prefered...Shift work
- ...safe, cost-effective, and medically necessary medication use. This role combines traditional dispensing responsibilities with prior authorization review and managed care coordination. Primary Responsibilities Process and dispense prescriptions accurately in compliance...Contract workRemote work
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