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Location: Remote
Duration: 6+ months contract
Shift: Monday-Friday 9:30am-6pm local time zone
Job Description:
* The Pharmacist/Clinician is an operation-based role that conducts criteria based & clinical rev...

This position is responsible for obtaining prior authorizations for all procedural orders by successfully completing the prior authorization process per department procedure and protocol.
Our Mission: Quality, compassionate care for all.
Our Vision: Reimagine health care through connection, service and innovation.
Our Core Values: Be Kind | Trust and Be Trusted | Work Together | Strive for Exce...

Job Type
Full-time
Description
Location: Remote
Compensation: $17.13 per hour
Schedule: Friday-Monday Monday - Friday, 8:00am-5:00pm PST, 40 hours a week
Ideal Option has been working on the front lines of the opioid epidemic since our first clinic opened in 2012. With more than 80 clinics across 9 states, we continuously strive to be the nation's leading provider of low-barrier evidence-based...

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...

This position is responsible for obtaining prior authorizations for all procedural orders by successfully completing the prior authorization process per department procedure and protocol.
Our Mission: Quality, compassionate care for all.
Our Vision: Reimagine health care through connection, service and innovation.
Our Core Values: Be Kind | Trust and Be Trusted | Work Together | Strive for Ex...

Authorization and Verification Research Specialist
Remote | Full time | 40 hours/week
About the Role
We're looking for a detail-oriented insurance verification and prior authorization expert who thrives on research and problem-solving. In this role, you'll investigate payor requirements across insurance plans—digging into portals, policy updates, and submission processes—to uncover the spe...

Description
Location: Remote
Compensation: $17.13 per hour
Schedule: Friday-Monday Monday - Friday, 8:00am-5:00pm PST, 40 hours a week
Ideal Option has been working on the front lines of the opioid epidemic since our first clinic opened in 2012. With more than 80 clinics across 9 states, we continuously strive to be the nation’s leading provider of low-barrier evidence-based treatment for o...

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...

Job Profile Summary
Position Purpose:
Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
Education/Experience:
Req...

Top Healthcare Provider Network
The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors' practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specia...

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 documentation of reviews.
* Transfers all clinic...

Job Description
UW Medicine Primary Care - Prior Authorization Team has an outstanding opportunity for a Patient Services Specialist 2- Prior Authorization Specialist.
WORK SCHEDULE
* Full-time, 100% FTE (40 hours per week)
* Monday - Friday; 8am-5pm
* Day Shift
DEPARTMENT DESCRIPTION
Conveniently located along I-5 near the Northgate Transit Center, UW Medicine Primary Care at North...

AHCCCS
Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid prog...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3....

AHCCCS
Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid prog...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
*Applicants for the job have the flexibility to work remote from home anywhere in the United States. Candidates must ...

The Virtual Access and Reimbursement Manager (vARM) will be responsible for educating healthcare providers (HCPs) and their staff on product-specific prior authorization and appeals processes, including how to access necessary forms and submission procedures. Field Force Collaboration will be critical for this role. The vARM is a remote employee who will virtually engage with accounts from an a...

Overview
Hello humankindness
Dignity Health Medical Group is the employed physician group of Dignity Health Arizona. Dignity Health Medical Group (DHMG) employs approximately 200 providers and 500 support staff that cover a wide variety of specialties. The medical group has had tremendous success over the past few years and now provides more than 73 sub-specialty services. The physicians provid...

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...

Remote Pharmacy Technician
Job Description
We are seeking a dedicated Pharmacy Technician to track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients. This role is essential in ensuring efficient processing and decision-making regarding medication coverage.
Responsibilities
* Track and triage coverage determination requests submitted ...