Prior Authorization Specialist II, Pharmacy Services CFHP

Full Time 12238 Silicon Drive Allied Health Day Shift POSITION SUMMARY/RESPONSIBILITIES: Prepares pharmacy prior authorization requests for review by nurse/pharmacist/physician reviewers. Completes pharmacy authorization requests and issues review outcome notifications to Community First Health Plans (CFHP) members and providers. Follows clinical...

Full Time 12238 Silicon Drive Professional Non-Nursing Day Shift POSITION SUMMARY/RESPONSIBILITIES Responsible for the administration of pharmaceutical services to CFHP members for all lines of business. Implements decisions set forth by the CFHP Pharmacy & Therapeutics Committee. Evaluates medication utilization and prior authorization requests for...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of...

The **Registered Pharmacy tech II** assists in preparing, packaging, delivering and charging of medications under the supervision of a licensed pharmacist. **MINIMUM EDUCATION**: High School Graduate or equivalent; accredited training in sterile products preparation. **MINIMUM EXPERIENCE**: Pharmacy experience **PREFERRED EXPERIENCE**: Two years hospital...

Seeking immediate hire to join our Business Office as an Authorization Specialist in a high-profile Sports Medicine Group supporting 18 physicians and 7 clinic locations. DUTIES INCLUDE, BUT ARE NOT LIMITED TO: Interpret insurance benefits and calculate patient responsibility Review chart documentation to ensure patient meets medical policy guidelines...

Job DescriptionJob DescriptionSeeking immediate hire to join our Business Office as an Authorization Specialist in a high-profile Sports Medicine Group supporting 18 physicians and 7 clinic locations. DUTIES INCLUDE, BUT ARE NOT LIMITED TO:Interpret insurance benefits and calculate patient responsibilityReview chart documentation to ensure patient meets...

4502 Medical Dr. Allied Health Rotating Shifts POSITION SUMMARY/RESPONSIBILITIES The Meds to Beds (MTB) Technician is responsible for enrolling patients into the bedside medication delivery program. In addition, the Meds to Beds technician will coordinate the filling, delivery, counseling, and billing of prescriptions to the patient's rooms prior to...

Full Time 4502 Medical Dr. Allied Health Rotating Shifts POSITION SUMMARY/RESPONSIBILITIES The Meds to Beds (MTB) Technician is responsible for enrolling patients into the bedside medication delivery program. In addition, the Meds to Beds technician will coordinate the filling, delivery, counseling, and billing of prescriptions to the patient's rooms...

Full Time 903 W. Martin Allied Health Rotating Shifts POSITION SUMMARY/RESPONSIBILITIES The Meds to Beds (MTB) Technician is responsible for enrolling patients into the bedside medication delivery program. In addition, the Meds to Beds technician will coordinate the filling, delivery, counseling, and billing of prescriptions to the patient's rooms prior...

Full Time 12238 Silicon Drive Clerical Day Shift POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator-Non-Clinical (SC-NC) supports medical, behavioral, and social support staff within the Service Coordination team to provide a holistic evaluation of STAR Kids Members' individual dynamics, needs and preferences while providing education and...

POSITION SUMMARY/RESPONSIBILITIES The Compliance & Regulatory Specialist is responsible for assisting in the oversight and execution of compliance in the health plan’s operational areas, including delegated operational activities and regulatory reporting. The candidate must be familiar with current Texas Medicaid regulations, the Texas Department of...

Full Time 12238 Silicon Drive Professional Non-Nursing Day Shift POSITION SUMMARY/RESPONSIBILITIES The Compliance & Regulatory Specialist is responsible for assisting in the oversight and execution of compliance in the health plan's operational areas, including delegated operational activities and regulatory reporting. The candidate must be familiar...

**Requirements**: - High School Diploma, GED or Equivalent - Minimum 1 year of prior authorization experience with knowledge of insurance verification - Minimum 1 year of processing and obtaining prior authorization requests for services rendered - Must have knowledge with both HMO and PPO plans for prior authorization - Experience with EMR such as EPIC -...

POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator-RN/NP/PA (SC-RN/NP/PA) provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The...

Service Coordinator (RN) Full Time 12238 Silicon Drive Nursing Day Shift POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being,...

Service Coordinator (RN)Full Time 12238 Silicon Drive Nursing Day Shift POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being,...

Service Coordinator (RN) Full Time 12238 Silicon Drive Nursing Day Shift POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being,...

Job DescriptionTop Client in need of Director of PharmacyJob SummaryThe Director of Pharmacy plans, organizes, controls, and supervises activities in hospital pharmacy according to hospital policies, standards, of practice of the profession, and State and Federal laws. Recommends innovations in the practice and function of the hospital pharmacy to...

The Director of Pharmacy plans, organizes, controls, and supervises activities in hospital pharmacy according to hospital policies, standards, of practice of the profession, and State and Federal laws. Recommends innovations in the practice and function of the hospital pharmacy to Administration and carries out mutually agreed upon programs.Job...

[California Pharmacy Technician License (TCH) - CA State Board of Pharmacy; Certified Pharmacy Technician (CPhT) - Pharmacy Technician Certification Board **Hours** **Shift Start Time**: Variable **Shift End Time**: Variable **Additional Shift Information**: Full Time - 8 hour shift **Weekend Requirements**: As Needed **On-Call Required**: No **Hourly Pay...