Columbus, OH · On-site
$119K - $198K/yr
Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT). * Strong analytical skills ...
Columbus, OH · On-site
$119K - $198K/yr
Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT). * Strong analytical skills ...
Columbus, OH · On-site
$119K - $198K/yr
Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT). * Strong analytical skills ...
Columbus, OH · On-site
$119K - $198K/yr
Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT). * Strong analytical skills ...
Columbus, OH · On-site
$17.33 - $26.59/hr
Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.
Columbus, OH · On-site
$17.33 - $26.59/hr
Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.
Columbus, OH · On-site +1
$119K - $198K/yr
Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT). * Strong analytical skills ...
Columbus, OH · On-site +1
$119K - $198K/yr
Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT). * Strong analytical skills ...
Columbus, OH · On-site
$17.33 - $26.59/hr
Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.
Columbus, OH · On-site
$17.33 - $26.59/hr
Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. • Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. • Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. · Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Quick apply
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. · Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. • Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. • Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. · Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Quick apply
Columbus, OH · On-site
$18.13 - $21.78/hr
... prior authorizations and handling medical records requests as requested by nursing management. · Process patient referrals for specialty care and follow-up, as needed, to ensure quality specialty ...
Columbus, OH · On-site
$23.80 - $27.79/hr
Review and complete daily tasks such as scanning, completing referral requests, answering phones, prior authorizations and handling medical records requests as requested by nursing management.
Columbus, OH · On-site
$23.80 - $27.79/hr
Review and complete daily tasks such as scanning, completing referral requests, answering phones, prior authorizations and handling medical records requests as requested by nursing management.
Ensure that test scenarios and scripts are accurate and comprehensive to completely validate all ... authorized to work in US are encouraged to apply. - Candidates must clear the Background check ...
Ensure that test scenarios and scripts are accurate and comprehensive to completely validate all ... authorized to work in US are encouraged to apply. - Candidates must clear the Background check ...
Columbus, OH · On-site
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Most of our positions require Candidate to ...
Columbus, OH · On-site
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Most of our positions require Candidate to ...
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Candidates must clear the Background check ...
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Candidates must clear the Background check ...
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Most of our positions require Candidate to ...
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Most of our positions require Candidate to ...
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Candidates must clear the Background check ...
... scripts, plans and procedures (manual and automated). 6. Work with the ODPS project team to test ... authorized to work in US are encouraged to apply. - Candidates must clear the Background check ...
Columbus, OH · On-site
$39.75 - $54.25/hr
... authorized environment. Key Responsibilities: * Test Strategy & Planning: Develop and execute ... User Acceptance Testing (UAT) Support: Assist the Business Analyst in preparing UAT scripts and ...
Quick apply
Columbus, OH · On-site
$39.75 - $54.25/hr
... authorized environment. Key Responsibilities: * Test Strategy & Planning: Develop and execute ... User Acceptance Testing (UAT) Support: Assist the Business Analyst in preparing UAT scripts and ...
Columbus, OH · On-site
$39.75 - $54.25/hr
... authorized environment. Key Responsibilities: * Test Strategy & Planning: Develop and execute ... User Acceptance Testing (UAT) Support: Assist the Business Analyst in preparing UAT scripts and ...
Columbus, OH · On-site
$39.75 - $54.25/hr
... authorized environment. Key Responsibilities: * Test Strategy & Planning: Develop and execute ... User Acceptance Testing (UAT) Support: Assist the Business Analyst in preparing UAT scripts and ...
Columbus, OH · On-site
Ability to show others how to use the tools like SCCM. 8. Ability to script with Powershell 2.0 or ... authorized to work in US are encouraged to apply. - Most of our positions require Candidate to ...
Columbus, OH · On-site
Ability to show others how to use the tools like SCCM. 8. Ability to script with Powershell 2.0 or ... authorized to work in US are encouraged to apply. - Most of our positions require Candidate to ...
Columbus, OH · On-site
Understanding of Active Directory, user authentication and authorization and identify and access ... Ability to script with Powershell 2.0 or above. Scripting abilities should include validation ...
Columbus, OH · On-site
Understanding of Active Directory, user authentication and authorization and identify and access ... Ability to script with Powershell 2.0 or above. Scripting abilities should include validation ...
$39.75 - $54.25/hr
... authorized environment. Key Responsibilities: * Test Strategy & Planning: Develop and execute ... User Acceptance Testing (UAT) Support: Assist the Business Analyst in preparing UAT scripts and ...
$39.75 - $54.25/hr
... authorized environment. Key Responsibilities: * Test Strategy & Planning: Develop and execute ... User Acceptance Testing (UAT) Support: Assist the Business Analyst in preparing UAT scripts and ...
$11.15 - $14.88
4% of jobs
$14.88 - $18.62
0% of jobs
$18.62 - $22.35
0% of jobs
$22.35 - $26.09
3% of jobs
$26.09 - $29.83
0% of jobs
$29.83 - $33.56
9% of jobs
$33.56 - $37.30
2% of jobs
$38.64 is the 25th percentile. Wages below this are outliers.
$37.30 - $41.03
17% of jobs
The median wage is $43.69 / hr.
$41.03 - $44.77
20% of jobs
$44.77 - $48.51
14% of jobs
$49.18 is the 75th percentile. Wages above this are outliers.
$48.51 - $52.24
31% of jobs
$11
$42
$52
To thrive as an Express Scripts Prior Authorization specialist, you typically need a background in pharmacy or healthcare, knowledge of prescription drug protocols, and experience with insurance processes. Familiarity with pharmacy benefit management (PBM) software, electronic health records (EHRs), and prior authorization platforms is important, as are any relevant pharmacy technician certifications. Strong attention to detail, excellent customer service abilities, and effective communication set top performers apart in this position. These skills ensure accurate and timely authorization processing, minimize errors, and support both patient care and pharmacy operations.
An Express Scripts Prior Authorization specialist is responsible for reviewing prescription requests, evaluating clinical information, and coordinating with prescribers, patients, and insurance providers to determine coverage eligibility. This role involves managing a high volume of cases, using proprietary systems to document and process authorizations, and frequently communicating via phone and electronic correspondence. Specialists must balance accuracy and efficiency while navigating complex healthcare regulations and helping resolve any issues that arise for patients facing prescription coverage barriers. The position often requires collaboration with pharmacists, physicians, and customer service teams to ensure seamless patient care.
An Express Scripts Prior Authorization job involves reviewing medication requests to ensure they meet insurance plan requirements before approval. Employees in this role assess prescriptions, follow clinical guidelines, and collaborate with healthcare providers to determine coverage eligibility. The job requires attention to detail, knowledge of pharmacy benefits, and strong communication skills. It helps ensure patients receive the most appropriate and cost-effective medications.
7.9
Based on 209 frontline employees who took The Breakroom Quiz
48th of 86 rated pharmaceutical
McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care.
What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you.
Sr.Product Manager
About The Team
As a Sr. Product Manager on thePayerePAteam, you will be at the forefront of ourPayer and PBMinitiatives, driving the strategy and execution ofsolutionsthat supportCoverMyMedsePA. You will collaborate closely with a talented team of developers, data analysts, and cross-functional stakeholders to deliver transformative solutions that meet market demands and enhance ourproduct offerings.Together with our various business units, thework ofourPayer Productteamhelpspeople get the medicine they need to live healthier lives.
Key Responsibilities:
Strategy & Roadmap
Define andmaintainthe product roadmap for the payerePAproduct line, translating market trends, regulatory developments (e.g., CMSePAmandates, FHIR-based prior authorization rules), and customer needs into prioritized initiatives.
SupportCMM's improvements for user identification and service authorization, connectingePAacross the Access suite to drivemeaningfulresults for our users and stakeholders.
Work with UX partners to conduct competitive analysis and market research toidentifyopportunities and inform product positioning in the payer market.
Develop and communicate a clear product vision to leadership and key stakeholders.
Product Development & Execution
Partner closely with engineering andotherproduct team membersto define clear, detailed product requirements and user stories and drive delivery milestones.
Define success metrics and KPIs for each product initiative, using data and analytics to measure outcomes and inform iterationtoachieve P&L budget.
Manage the full product lifecycle from discovery through launch and post-launch optimization.
Evaluate build/buy/partner decisions for new product capabilities.
Stakeholder & Cross-Functional Leadership
Partner closely with engineering, analytics, operations, and commercial teams to ensure alignment on priorities and dependencies.
Work with the implementations and commercial team to support go-to-market planning, sales enablement, and payer client engagement.
Represent the PayerePAproduct in customer conversations and payer-facing discussions as needed.
Qualifications:
Proven experience as a Product Manager, preferably inhealth techorPayer-facing fields.
Demonstrated experience owning a product roadmap end-to-end and driving cross-functional execution.
Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT).
Strong analytical skills; comfortable defining metrics, interpreting data, and using insights to drive decisions.
Excellent written and verbal communication skills; able to synthesize complexity for both technical and non-technical audiences.
Experienceworking withengineering teams todeveloptechnical solutionsto complexproblems.
Experience with agile development methodologies and tools.
Degree or equivalent andtypically requires 7+ years of
relevant experience.
Bachelor's degree in Computer Science, Engineering, Business, ora relatedfield preferred. An advanced degree is a plus
We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, pleaseclick here.
Our Base Pay Range for this position
$119,300 - $198,800McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind:
McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application.
McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates.
McKesson job postings are posted on our career site: careers.mckesson.com.
McKesson is an Equal Opportunity Employer
McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.
McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) Disability_Accommodation@McKesson.com or (Canada) Accessibility@mckesson.ca. Resumes or CVs submitted to this email box will not be accepted.
Join us at McKesson!
Sourced by ZipRecruiter
Health care and social assistance
10,000+ Employees
San Francisco, CA, US
2014
