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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...

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...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carri...

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.
Remote based position anywhere in the United States, must be available to work Monday - Friday; 10:30 a.m. 7:00 p.m. ...

The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line. The Specialist will be instrumental in obtaining written documentation, submitting tracking, reporting an...

Job Profile Summary
Position Purpose: Define and develop standard and custom formularies for assigned plan.
Education/Experience: Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.
Licenses/Certifications: Current state’s Pharmacist license with...

The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line. The Specialist will be instrumental in obtaining written documentation, submitting tracking, reporting an...

Job Profile Summary
Position Purpose:
Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program.
Education/Experience:
High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred.
For Superior Health Plan:
...

We anticipate the application window for this opening will close on - 15 Aug 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 Pelvic ...

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...

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....

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 3.5 m...

Exception Template-Clinical Formulary Pharmacist - 580221
Position Purpose: Define and develop standard and custom formularies for all lines of business including Commercial, Medicaid, Medicare Part D and the Health Information Marketplace
• Develop drug product review and formulary recommendations by assessing drug use trends, new drug releases and review of primary literature • Analyze ph...

The Financial Clearance Specialist II is responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties. Specialist II are responsible for documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient....

The Financial Clearance Specialist II is responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties. Specialist II are responsible for documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient....

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.
Position Purpose:
The Utilization Review Nurse I provides first level clinical review for all outpatient and ancilla...

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...

Job Title: REMOTE Pharmacy Technician 1
** if you are interested in this opportunity, please feel free to apply and email me your resume at alalfaro @ astoncarter.com so we can schedule a time to connect asap! **
Job Description
We are seeking a dedicated Pharmacy Technician to join our team, where you will play a crucial role in tracking and triaging coverage determination requests for prio...