Prior authorization management jobs

Pharmacy Benefits Specialist - Mail Order Services - Pharmacy Advantage

Henry Ford Health · Posted Nov 12, 2026

Open

Rochester Hills, Michigan, United States
Hybrid
Full-time
$2,500 sign-on bonus

Pharmacy Benefits Specialist - Mail Order Services - Pharmacy Advantage

Henry Ford Health · Posted Nov 12, 2026

Open

Rochester Hills, Michigan, United States
Hybrid
Full-time
$2,500 sign-on bonus

Patient Relations Administrator

Texas A&M University Health Science Center · Posted Nov 12, 2026

Open

Bryan, Texas, United States
On-site
Full-time · Staff
Commensurate
3+ years

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Help coordinate patient care by ensuring patient needs are addressed promptly through collaboration, communication, and coordination, including scheduling appointments, processing referrals, calling patients, and answering patient calls while handling Protected Health Information (PHI) as defined by HIPAA.

Responsibilities

Contacts patients' insurance carriers to perform specialized verification of behavioral health benefits, copay structures, deductibles, and pre-authorization requirements prior to scheduled encounters.
Submits, tracks, and manages prior authorization (PA) requests for IBH referrals reviewed by the clinical team, documenting status updates directly in the EHR.
Serves as the primary point of contact for insurance inquiries and coverage clarifications related to integrated behavioral health services.
Guides patients through fee-for-service financial agreements and ensures required informed consent documentation is fully explained and signed prior to the clinical encounter.
Addresses patient questions, concerns, and payment discussions regarding behavioral health billing during warm handoffs or scheduled visits.

Requirements

Associates degree or equivalent combination of training and experience

Skills

Insurance Verification Prior Authorization Management

Authorization Representative

UW Health · Posted Nov 11, 2026

Open

Middleton, Wisconsin, United States
Hybrid
Full-time · Associate
1+ years

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Support timely patient access to care by obtaining and managing required prior authorizations for healthcare services.

Responsibilities

Obtain and manage required prior authorizations for healthcare services
Prevent avoidable denials by securing authorizations and verifying coverage prior to services being rendered
Build collaborative relationships with patients, providers, and insurance payers through effective communication and exceptional customer service
Proactively identify and resolve authorization, coverage, and payer-related issues
Contribute to continuous improvement initiatives by embracing automation, process enhancements, and operational efficiencies

Requirements

High school diploma or equivalent
Associate’s Degree in Business, Finance, Health Information Management, or a related field
Nice to have: Healthcare Revenue Cycle experience

Skills

Prior authorization management Coverage verification CPT coding ICD coding Medicare regulations

Pharmacy Benefits Specialist - Pharmacy Advantage Mail Order

Henry Ford Health · Posted Nov 9, 2026

Open

Rochester Hills, Michigan, United States
Hybrid
Full-time
$2,500 sign-on bonus
2+ years

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Support patients and providers by helping navigate pharmacy benefits and coordinating prescription services.

Responsibilities

Collaborate with Mail Order Services Department
Support patients with maintenance medications
Prescription intake
Adherence reminder calls
Delivery coordination

Requirements

High school diploma or G.E.D.
Associates degree preferred
State of Michigan Pharmacy Technician License.
Nice to have: specialty pharmacy technician experience

Skills

pharmacy technician experience prescription intake adherence reminder calls delivery coordination insurance benefits investigation prior authorization management financial assistance research

Specialty Pharmacist

UnitedHealth Group · Posted Jan 1, 2024

Open

Connecticut, United States +1 more
On-site
Full-time · Staff

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Provide high-touch support to patients with complex, specialty diseases, helping them achieve better outcomes through personalized care and consistent engagement.

Locations (2)

Connecticut, United States
New York, United States

Responsibilities

Review and manage specialty medication therapies for complex, chronic, or high-cost conditions
Provide patient education and counseling, focusing on adherence, administration, side effects, and outcomes
Coordinate care with providers, payers, and manufacturers to ensure therapy access and continuity
Oversee prior authorizations and utilization management, ensuring compliance with payer and program requirements
Monitor effectiveness and safety of therapy, including lab values, adherence metrics, and patient-reported outcomes

Requirements

Specialty Pharmacist

Skills

Medication Access Specialist Technician

Brown Medicine · Posted Nov 6, 2026

Open

Providence, Rhode Island, United States
$27–$28 per hour
2+ years

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Medication Access Specialist Technician

Compensation

$26.67-$27.75

Responsibilities

Exhibits a friendly, pleasant, and helpful nature demonstrating a strong customer service orientation when interacting with customers/patients, providers, nurses, and support personnel.
Maintains and supports pharmacy interdepartmental relationships to ensure seamless transition of patient care from clinic to pharmacy.
Participates in the growth of the Specialty Pharmacy patient population through face-to-face patient interaction and recruitment.
Responds to questions relative to cost and availability of medication and pharmaceutical supplies.
Informs customers/patients, providers and support personnel of wait times and any issues regarding drug availability, including advising on the refill authorization process for expired prescription orders.

Requirements

High school graduate or equivalent degree
Completion of one to two years of college preferred
Nice to have: Benefits Management
Nice to have: Manufacturer Assistance Programs
Nice to have: National Pharmacy Technician Certification (CPhT)

Skills

Pharmacy Technician

Medication Access Specialist Technician

Brown Medicine · Posted Nov 6, 2026

Open

Providence, Rhode Island, United States
$27–$28 per hour
2+ years

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Medication Access Specialist Technician responsible for preparing, formulating, and packaging medication and pharmaceutical supplies in a specialty pharmacy setting.

Compensation

Pay Range: $26.67-$27.75

Responsibilities

Exhibits a friendly, pleasant, and helpful nature demonstrating a strong customer service orientation when interacting with customers/patients, providers, nurses, and support personnel.
Maintains and supports pharmacy interdepartmental relationships to ensure seamless transition of patient care from clinic to pharmacy.
Participates in the growth of the Specialty Pharmacy patient population through face-to-face patient interaction and recruitment.
Responds to questions relative to cost and availability of medication and pharmaceutical supplies.
Informs customers/patients, providers and support personnel of wait times and any issues regarding drug availability, including advising on the refill authorization process for expired prescription orders.

Requirements

High school graduate or equivalent
Completion of one to two years of college preferred
Nice to have: Benefits Management
Nice to have: Manufacturer Assistance Programs
Nice to have: Nationally Recognized Foundations

Skills

Pharmacy Technician