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Remote Prior Authorization Representative Express Scripts Jobs in Florida

Ennoble Care

Care Coordinator

Orlando, FL · Remote

$75K - $85K/yr

Process and route incoming referrals, lab orders, prior authorizations, and home health orders to ... Remote position based in Central Florida (Orlando metro area preferred) * Must be available during ...

Ennoble Care

Care Coordinator

Orlando, FL · Remote

$75K - $85K/yr

Process and route incoming referrals, lab orders, prior authorizations, and home health orders to ... Remote position based in Central Florida (Orlando metro area preferred) * Must be available during ...

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All JobsPrior Authorization Representative Express Scripts JobsRemote Prior Authorization Representative Express Scripts JobsRemote Prior Authorization Representative Express Scripts Jobs in Florida

Remote Prior Authorization Representative Express Scripts information

What is the difference between Remote Prior Authorization Representative Express Scripts vs Remote Claims Processor?

AspectRemote Prior Authorization Representative Express ScriptsRemote Claims Processor
CredentialsHigh school diploma, healthcare certifications often preferredHigh school diploma, healthcare or insurance certifications
Work EnvironmentRemote, healthcare insurance settingRemote, insurance claims processing environment
Employer & IndustryExpress Scripts, healthcare/pharmacy industryVarious insurance companies, healthcare industry
Primary ResponsibilitiesReview and approve prior authorization requestsReview and process insurance claims

The Remote Prior Authorization Representative at Express Scripts focuses on evaluating and approving prior authorization requests for medications, ensuring timely patient access. In contrast, a Remote Claims Processor handles the review and processing of insurance claims after services are rendered. While both roles require healthcare knowledge and remote work skills, their core functions differ in the stages of the insurance process they manage.

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Remote Prior Authorization Representative Express Scripts jobs near you

Case Management Pharmacist (Remote)

Pharmacy Careers

Miami, FL • On-site, Remote

Other

Posted 19 days ago

Job description

Case Management Pharmacist - Coordinate Care and Improve Patient Outcomes
A confidential managed care organization is hiring a detail-oriented Case Management Pharmacist to support patients with complex medication needs. This role focuses on coordinating care, preventing medication-related issues, and ensuring members receive the most appropriate therapy at the right time.
Key Responsibilities

  • Collaborate with physicians, nurses, and care coordinators to manage high-risk or complex patients.
  • Conduct medication reviews to identify gaps in therapy, adherence concerns, or potential drug interactions.
  • Support prior authorization and appeals processes when needed.
  • Educate patients and caregivers on medication regimens and disease state management.
  • Document case activities and outcomes in compliance with health plan and regulatory standards.
  • Participate in quality improvement initiatives to reduce hospitalizations and improve health outcomes.


What You'll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Case management, MTM, or managed care experience preferred - retail and hospital pharmacists with strong patient counseling backgrounds are encouraged to apply.
  • Skills: Strong communication, problem-solving, and care coordination skills.


Why This Role?

  • Impact: Make a meaningful difference in patients' lives by ensuring safe and effective medication use.
  • Growth: Develop expertise in case management and managed care pharmacy.
  • Flexibility: Many organizations offer hybrid or fully remote work options.
  • Rewards: Competitive pay, benefits, and career advancement opportunities.

About Us
We are a confidential healthcare partner serving health plans and provider networks nationwide. Our case management pharmacists play a vital role in improving outcomes, reducing readmissions, and supporting patients across the continuum of care.
Apply Today
Apply now for our Case Management Pharmacist opportunity and join a team dedicated to patient-centered, coordinated care.

Apply