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POSITION SUMMARY :
Responsible for screening prior-authorization and coordination of specialized services requests in the medical care management program, including a broad range of requests for inpatient, outpatient and ancillary services. Adheres to policies and procedures in order to comply with performance and compliance standards and to ensure cost effective and appropriate healthcare deli...

Company Description
Guardant Health is a leading precision oncology company focused on guarding wellness and giving every person more time free from cancer. Founded in 2012, Guardant is transforming patient care and accelerating new cancer therapies by providing critical insights into what drives disease through its advanced blood and tissue tests, real-world data and AI analytics. Guardant tes...

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choo...

Job Title: Prior Authorization Specialist
Location: Fully remote
Duration: 12 months contract
Job Description:
* Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process.
* Maintains complete, timely and accurate documenta...

About DrFirst
This is a great opportunity to be a part of a successful Healthcare IT company experiencing significant growth. We have proven products that address the leading causes of gaps in patient care, brand-name customers, significant growth opportunities and are backed by leading investors. Here you'll get to work with some of the smartest and most interesting people around; solving uniq...

Job Description:
* Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process.
* Maintains complete, timely and accurate documentation of reviews.
* Transfers all clinical questions, escalations and judgement calls to the phar...

Location:
Work from home (Pennsylvania)
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
No
Job Summary:
Accountable to obtain prior authorization for medications. Complete benefit investigation to determine coverage for prescribed treatment and act as a liaison for all medication prior authorization matters to insurance companies, de...

JOB SUMMARY
The Revenue Cycle Management Clinician for the Pre-Authorization Solution is responsible for:
* All clinical pre-authorization activities associated with patients financially cleared through the Patient Access Support Unit (PASU) and/or the Center for Patient Access Services (CPAS).
* Coordinating with ordering physicians and/or facility staff to secure the necessary pri...

We anticipate the application window for this opening will close on - 23 May 2025
At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You'll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world.
A Day in the Life
Patient Access Support Specialist supporting CRDN
The...

We anticipate the application window for this opening will close on - 23 May 2025
At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You'll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world.
A Day in the Life
The Patient Access Support Specialist for the Coronar...

Overview
The Clinical Formulary Pharmacist is responsible for providing operational support for the evaluation, creation, maintenance, and implementation of standard and custom Medicare Part D Formularies. In addition, this role will work on utilization management, drug lists, and preparation of CMS formulary files. This role will work with the team to ensure all Formulary Management and Dru...

Peoples Injury Network Northwest, a brand partner of Upstream Rehabilitation, is looking for a Clinical Authorization Coordinator to join our team in Washington State, US
Are you looking for a position in a growing organization where you can make a significant impact on the lives of others?
JOB SUMMARY:
Responsible for working with clinic staff, insurance companies and relevant third parti...

Location:
Avera Health
Worker Type:
Regular
Work Shift:
Day Shift (United States of America)
Pay Range:
The pay range for this position is listed below. Actual pay rate dependent upon experience.
$18.25 - $23.75
Position Highlights
You Belong at Avera
Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.
...

Company Overview
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership ...

Job Details
Job Location: Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Position Type: Full Time Salary Range: Undisclosed Job Category: Pharmaceutical
Description
PRIOR AUTHORIZATION SPECIALIST (REMOTE)
WHO WE ARE
Polaris Pharmacy Services is an industry leader in both the Long-Term Care and Post-Acute Care settings. Founded in 2015, we are locally and i...

City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans is hiring for a Manager, Clinical Pharmacy for Prior Authorization- Remote!
Status: Full-time, permanent position (40 hours)
Work hours: 8am to 5pm EST, M-F
Location: This position is fully remote for candidates that live in the following states: VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE...

City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans is hiring for a Manager, Clinical Pharmacy for Prior Authorization- Remote!
Status: Full-time, permanent position (40 hours)
Work hours: 8am to 5pm EST, M-F
Location: This position is fully remote for candidates that live in the following states: VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE...

Dentsply Sirona is the world's largest manufacturer of professional dental products and technologies, with a 130-year history of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering including dental and oral health products as well as other consumable medical devices under a strong portfolio ...

Become a part of our caring community and help us put health first
Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market (iCare) team. The UM Coordinator provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Join this dedicated team and lead change in how health car...