Home, KS · On-site
$94K - $176K/yr
Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist Position supporting Medicaid Prior Authorization. An active AZ or TX ...
Home, KS · On-site
$94K - $176K/yr
Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist Position supporting Medicaid Prior Authorization. An active AZ or TX ...
Topeka, KS · On-site
$17 - $22/hr
... authorization process Preferred ... Prior experience in imaging, specialty clinics, or hospital-based referrals Preferred * Experience ...
Topeka, KS · On-site
$17 - $22/hr
... authorization process Preferred ... Prior experience in imaging, specialty clinics, or hospital-based referrals Preferred * Experience ...
Topeka, KS · On-site +1
$17 - $22/hr
... authorization process Preferred ... Prior experience in imaging, specialty clinics, or hospital-based referrals Preferred * Experience ...
Topeka, KS · On-site +1
$17 - $22/hr
... authorization process Preferred ... Prior experience in imaging, specialty clinics, or hospital-based referrals Preferred * Experience ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Lawrence, KS · On-site
$19 - $25/hr
Benefits, Prior Authorizations, and Patient Responsibility * Verify dental benefits and coverage information as needed to support treatment planning and patient communication. * Complete, submit, and ...
Wichita, KS · On-site
Obtains prior authorization for scans, labs, subsequent chemotherapy visits or any other service as required. * Maintains a professional working relationship with co-workers, insurance companies and ...
Wichita, KS · On-site
Obtains prior authorization for scans, labs, subsequent chemotherapy visits or any other service as required. * Maintains a professional working relationship with co-workers, insurance companies and ...
Wichita, KS · On-site
Obtains prior authorization for scans, labs, subsequent chemotherapy visits or any other service as required. * Maintains a professional working relationship with co-workers, insurance companies and ...
Wichita, KS · On-site
Obtains prior authorization for scans, labs, subsequent chemotherapy visits or any other service as required. * Maintains a professional working relationship with co-workers, insurance companies and ...
Obtains prior authorization for scans, labs, subsequent chemotherapy visits or any other service as required. * Maintains a professional working relationship with co-workers, insurance companies and ...
Obtains prior authorization for scans, labs, subsequent chemotherapy visits or any other service as required. * Maintains a professional working relationship with co-workers, insurance companies and ...
Lenexa, KS · Remote
$17 - $23/hr
Prior Authorization & Clinical Review * Review payor requirements and determine authorization needs. * Gather and compile clinical documentation required for authorization submission. * Assemble ...
Lenexa, KS · Remote
$17 - $23/hr
Prior Authorization & Clinical Review * Review payor requirements and determine authorization needs. * Gather and compile clinical documentation required for authorization submission. * Assemble ...
Wichita, KS · On-site
Must have prior authorization utilization experience * Experience with Medcompass Skills: * MUST HAVE MEDCOMPASS or ASSURECARE exp. * MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.
Wichita, KS · On-site
Must have prior authorization utilization experience * Experience with Medcompass Skills: * MUST HAVE MEDCOMPASS or ASSURECARE exp. * MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.
Lenexa, KS · On-site
$17 - $23/hr
Prior Authorization & Clinical Review * Review payor requirements and determine authorization needs. * Gather and compile clinical documentation required for authorization submission. * Assemble ...
Lenexa, KS · On-site
$17 - $23/hr
Prior Authorization & Clinical Review * Review payor requirements and determine authorization needs. * Gather and compile clinical documentation required for authorization submission. * Assemble ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and ...
Independently review, research, and resolve prior authorization requests by applying clinical criteria, established guidelines, and professional judgment within defined protocols * Communicate ...
Independently review, research, and resolve prior authorization requests by applying clinical criteria, established guidelines, and professional judgment within defined protocols * Communicate ...
$12.22 - $13.72
6% of jobs
$13.72 - $15.22
14% of jobs
$15.60 is the 25th percentile. Wages below this are outliers.
$15.22 - $16.72
20% of jobs
The median wage is $17.56 / hr.
$16.72 - $18.22
18% of jobs
$18.22 - $19.72
16% of jobs
$19.89 is the 75th percentile. Wages above this are outliers.
$19.72 - $21.22
12% of jobs
$21.22 - $22.72
7% of jobs
$22.72 - $24.23
5% of jobs
$24.23 - $25.73
2% of jobs
$25.73 - $27.23
0% of jobs
$27.23 - $28.73
0% of jobs
$12
$18
$28
| Aspect | Prior Authorization | Medical Billing Specialist |
|---|---|---|
| Credentials | Typically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like NCQA or AHIP | Requires knowledge of coding, billing procedures, and often certifications like CPC or CCS |
| Work Environment | Healthcare provider offices, insurance companies, or hospitals | Medical offices, billing companies, or healthcare facilities |
| Employer & Industry Usage | Used by healthcare providers and insurers to approve treatments or procedures | Used by healthcare providers and billing companies to process claims and payments |
While both roles are essential in healthcare administration, Prior Authorization focuses on obtaining approval for treatments, whereas Medical Billing Specialists handle the financial aspects of claims processing. Understanding their differences helps clarify their distinct responsibilities within the healthcare system.
The most popular types of Prior Authorization jobs in Kansas are:
For Prior Authorization jobs in Kansas, the most frequently searched job titles are:
The top searched job categories for Prior Authorization jobs in Kansas are:
Cities in Kansas with the most Prior Authorization job openings:
Home, KS • On-site
$94K - $176K/yr
Other
Medical, Dental, Vision, Retirement, PTO
Posted 6 days ago
5.8
Based on 4,341 frontline employees who took The Breakroom Quiz
91st of 113 rated pharmacies
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
Ready to take your clinical skills to the next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna!
This is a Clinical Pharmacist Position supporting Medicaid Prior Authorization.
An active AZ or TX pharmacist license that is in good standing is required. New hire is required to obtain AZ or TX pharmacist license (whichever they currently do not have) within 90 days of hire.
We are hiring for the 10:00 am - 6:30 pm shift AZ time (post training). The training schedule is: 8:00 am - 4:30 pm AZT (8 weeks).
You are required to work one Saturday every 6 weeks and occasional holidays.
This is a fully remote position open to qualified candidates within the United States.
Required Qualifications
Active and unrestricted AZ and/or TX pharmacist license required. Candidate must currently hold one of these licenses.
New hire is required to obtain additional AZ or TX pharmacist license (whichever they do not currently hold) within 90 days of hire.
Experience with clinical decision-making while applying evidence based clinical guidelines/criteria; utilizing formularies/preferred drug lists.
Experience working in a high production managed care team environment
3+ years experience working as a pharmacist.
Demonstrated understanding of clinical program components, formulary designs, and prescription benefit trends.
Preferred Qualifications
Medicaid or Medicare experience
Prior authorization experience.
Experience reviewing medical records, clinical literature, and composing SOAP notes.
Education
BS in Pharmacy or PharmD
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$94,500.00 - $176,000.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .
We anticipate the application window for this opening will close on: 08/24/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.
Get the full story on Breakroom
Sourced by ZipRecruiter
Health care and social assistance and retail
10,000+ Employees
Woonsocket, RI, US
