Newark, DE · Remote
$57 - $68.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Newark, DE · Remote
$57 - $68.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Dover, DE · Remote
$58.25 - $70/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Dover, DE · Remote
$58.25 - $70/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Dover, DE · On-site +1
$57.25 - $69.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Dover, DE · On-site +1
$57.25 - $69.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Newark, DE · On-site +1
$56 - $68.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Newark, DE · On-site +1
$56 - $68.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Delaware City, DE · Remote
$55K - $67.50K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... li-remote Based on the nature of this role, you will need to complete several state background ...
Quick apply
Delaware City, DE · Remote
$55K - $67.50K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... li-remote Based on the nature of this role, you will need to complete several state background ...
DE · Remote
$119K - $190.40K/yr
Remote in the US This role is contributing to the ELSE Data Center Services Center of Excellence in ... through reviews, proper project closure, KPI achievement (revenue, utilization, margin ...
DE · Remote
$119K - $190.40K/yr
Remote in the US This role is contributing to the ELSE Data Center Services Center of Excellence in ... through reviews, proper project closure, KPI achievement (revenue, utilization, margin ...
DE · Remote
The role is a remote position; location base will be reviewed as this position covers all regions ... Enhance data utilization capabilities and enable stronger data led decision making in setting ...
DE · Remote
The role is a remote position; location base will be reviewed as this position covers all regions ... Enhance data utilization capabilities and enable stronger data led decision making in setting ...
Wilmington, DE · On-site +1
Establish metrics and dashboards to measure adoption progress, content utilization, and overall ... Strong ability to build or review reusable starter kits, templates, and reference code. Deep ...
Wilmington, DE · On-site +1
Establish metrics and dashboards to measure adoption progress, content utilization, and overall ... Strong ability to build or review reusable starter kits, templates, and reference code. Deep ...
Wilmington, DE · On-site +1
Establish metrics and dashboards to measure adoption progress, content utilization, and overall ... Strong ability to build or review reusable starter kits, templates, and reference code. Deep ...
Wilmington, DE · On-site +1
Establish metrics and dashboards to measure adoption progress, content utilization, and overall ... Strong ability to build or review reusable starter kits, templates, and reference code. Deep ...
| Aspect | Remote Bcba Utilization Review | Remote Bcba Case Manager |
|---|---|---|
| Certifications | BCBA, possibly additional utilization review credentials | BCBA, case management certifications often preferred |
| Work Environment | Reviewing medical and treatment plans remotely, focusing on insurance and authorization | Coordinating care, managing cases, and supporting clients remotely |
| Employer & Industry | Healthcare, insurance companies, behavioral health providers | Behavioral health agencies, healthcare organizations |
Both roles require BCBA certification and involve remote work, but the Utilization Review focuses on evaluating treatment plans for insurance approval, while the Case Manager manages ongoing client care and services. Understanding these differences helps professionals choose the right career path in behavioral health.
$57 - $68.50/hr
Other
Posted 4 days ago
Remote Prior Authorization Pharmacist - Work From Home in Managed Care
A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.
Key Responsibilities
What You'll Bring
Why This Role?
About Us
We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.
Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.
