Remote PA Pharmacist: Appeals & Prior Authorization
Sarasota Memorial Hospital
- Remote job
UnitedHealth Group is seeking a Pharmacist PA/Appeals for remote work in Maine and Vermont. The role involves clinical review, decisioning, and communication related to prior authorization and appeals, using established criteria and regulatory guidelines. You will collaborate with providers, members, and internal teams to ensure timely, accurate determinations. Responsibilities include researching medication details, documenting actions, and handling inquiries, with emphasis on privacy, quality, #J-18808-Ljbffr Sarasota Memorial Hospital
$44 - $79 per hour
...Pharmacist At UnitedHealthcare, we're simplifying the health care experience... ...interactions, and clinical status for appeals requests Conduct Quality... ...communication ~1+ years of experience of prior authorization case review & rendering PA decisions ~ Intermediate level...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday- UnitedHealth Group seeks a Pharmacist PA/Appeals to join as a remote clinician supporting Vermont and Maine operations. The role focuses on prior authorization reviews, appeals determinations, and collaboration with providers, members, and internal teams to ensure compliant...Remote jobHome office
$44 - $79 per hour
...Pharmacist PA/Appeals - Remote in Vermont & Maine Optum is a global organization that delivers care, aided by technology to help millions... ...start Caring. Connecting. Growing together. As a Prior Authorization Pharmacist, you will support clinical review, decisioning...Remote jobHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to FridayFlexible hoursShift work- UnitedHealth Group seeks a Pharmacist PA/Appeals for remote work supporting Vermont and Maine. The role focuses on clinical review, decisioning, and appeals in pharmacy prior authorization, with collaboration across providers, members, and internal teams. Responsibilities...Remote job
$59 per hour
...Job Description Job Description Remote Prior Authorization and Appeals Pharmacist Compensation: $59/hr Duration : 6 – 10 months, contract to hire... ...Description: The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating...Remote workContract workLocal areaImmediate startShift work- UnitedHealth Group is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals processes. The role involves handling inquiries... ...systems, and ensuring complete documentation. Remote work available for Maine or Vermont residents, with...Remote jobShift workWeekend work
$75 per hour
...Dorsey . Position: Pharmacy Prior Authorization & Specialty-Medication Access... ...: $75/hour Location: Remote Role Responsibilities... ...medication authorisations. Manage appeals for denied pharmacy... ...therapy protocols, and payer PA criteria across commercial and...Remote workContract workSummer work- ...Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers... ...Appeals Technician include supporting the prior authorization and appeals process by providing... ...professional service to members, providers, pharmacists, and internal business partners. This...Remote jobTemporary workFlexible hoursShift work
$18 - $32 per hour
...Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers... ...exists to take incoming requests for prior authorizations, for formulary and non-formulary medications... ..., from providers' offices and pharmacists. The position provides clinical review...Remote jobHourly payDaily paidMinimum wagePrice workFull timeTemporary workWork experience placementWork at officeLocal areaFlexible hoursShift work$55.28 - $57.69 per hour
...Clinical Consulting Pharmacist Schedule: Monday - Friday, 2:30PM... ...:00PM EST Must reside in PA or TN to be considered. Dragonfly... ...on medication requests, prior authorizations, and benefit determinations.... ...complex case reviews and appeals with accurate clinical...Remote jobRelocation packageMonday to FridayShift work$128k - $160k
...as subject matter expert on prior authorization and appeals operations that are... ...processes of prior authorization pharmacists, staff schedules, skilling,... ...for select administrative PA functions. Oversight of appeal... ...leadership experience in a remote environment. This position...Remote workContract workWork at officeLocal areaMonday to FridayFlexible hoursShift workWeekend work- A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy... ...be responsible for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in a team...Remote work
$107k - $127k
...Description Senior Managed Care Pharmacist – Formulary /... ...Therapeutics Strategy (PA Licensed) Role Type:... ...Work Arrangement: 100% Remote / Work from Home... ...Communications Lifecycle: Author and revise multi-channel... ...utilization management (Prior Authorization, Step Therapy...Remote workPermanent employmentFull timeContract workWork from homeMonday to FridayShift 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... ..., and clinical status for appeals requests Conduct Quality... ...in Coverage Determinations (prior authorization) or member appeals...Remote jobHourly payWork experience placement$101.6k - $133k
...reviewing clinical coverage determination and appeals for different lines of business such as... ...detailed and thorough documentation in prior authorization cases, appeals cases, and overrides.... ...supervision, stay productive in a remote, high-volume, metric driven environment...Remote workTemporary workWork at officeLocal areaFlexible hoursShift work- ...knowledgeable, and highly trained pharmacists and support staff, plays a... ..., coordinating prior authorizations and appeals, and ensuring timely patient... ...payer prior authorization (PA) & appeal portals (e.g. CoverMyMeds... ...may be applied for remote employees who reside out...Remote workFull timeWork at officeMonday to FridayShift work
- ...Position Title: Clinical Pharmacist 1 Work Location: Remote Assignment Duration:... ...Position Summary: Pharmacy Appeals Department - Dept 247... ...Ops Dept includes PA and Appeals - no key projects... ...* Reviews a completed prior authorization request received from the...Remote workWork at office
- ...Location: Pittsburgh, PA Licensure Required: PharmD... .... Monitors and oversees Prior Authorization and Appeals. Serves as primary point... ...of Pharmacy or Registered Pharmacist degree from an ACPE accredited... .... Benefits: Hybrid, remote and flexible on-site work schedules...Remote workFull timeTemporary workPart timeWork at officeLocal areaFlexible hours
- ...Ambulatory Clinical Pharmacist Our team members are at the... ...role. Location: Hybrid/remote (Pennsylvania) with some... ...required in West Reading, PA for training, quarterly... ...affordability. Prepare and submit prior authorizations, manage denials/appeals. Demonstrate ability...Remote jobFull timeWork at officeMonday to Friday
- ...Utilization Management Clinical Pharmacist, you will join TruDataRx’s... ...Evaluate and adjudicate prior authorization (PA) requests for accuracy and... ...Evaluate and adjudicate appeal requests for clinical appropriateness... ...case reviews. Remote Productivity: Self-motivated...Remote work
$22 per hour
...Call Center Representative in Detroit, MI. This is a temporary remote position, offering a pay rate of $22/hr. Candidates should... ...School Graduate. Join a dynamic team supporting Medicare Part B drug coverage inquiries and prior authorizations. #J-18808-Ljbffr TekWissen ®Remote jobTemporary work- ...seeks an experienced subject matter expert in prior authorization and appeals, ensuring compliance with federal and state standards... ...multiple lines of business. You will oversee PA processes, supervision of appeal pharmacists, and staff scheduling, with a focus on...
- ...Remote Appeals Pharmacist - Fair Medication Access | Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy in a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based guidelines, and ensure fair...Remote workWork from home
- ..., the full-time salaried Registered Pharmacist will conduct Prior Authorization reviews for Medicaid and Marketplace... ...collaborate with pharmacy staff in a remote work environment. Key... ...to members and providers regarding PA decisions Assist pharmacy technicians...Remote workFull time
- ...Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers... ...Appeals Technician include supporting the prior authorization and appeals process by providing... ...professional service to members, providers, pharmacists, and internal business partners. This...Remote jobMonday to FridayShift workAfternoon shift
- Judi Health seeks a subject matter expert in prior authorization and appeals to ensure regulatory compliance across Commercial, Medicare, and Medicaid lines. You will oversee PA workflows, mentor staff, and manage clinical denial language while collaborating with managers...
- ...Remote Case Management Pharmacist Coordinate care for complex patients | Work from home support high-risk and complex patients through... ...concerns, or potential interactions. Support prior-authorization and appeals processes when needed. Educate patients and caregivers...Remote work
- ...About the job Remote Coverage Review Pharmacist Remote Coverage Review Pharmacist needs 3 years and Doctor... ...activities associated with coverage reviews and appeals including the review of medication related prior authorizations, pharmacy appeals, and member grievances...Remote workWork at office
- Judi Health is seeking a Clinical Appeals Reviewer to review coverage determinations and appeals for Commercial and Medicare lines, ensuring... ...with thorough detail, while maintaining turnaround times in a remote environment. This remote role allows you to work from a secure...Remote jobWork from homeHome office
$130k - $150k
...Pharmacist In Charge (Specialty) - Lufkin, TX House Rx is on a... ...therapeutic substitution, and prior authorization reviews Be the workflow expert... ...access, including composing appeal letters and seeking any... ...matter how radical. We are a remote-first company, however some...Remote workFull timeWork from home
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