Pharmacist

1 day ago

Lahore, Punjab, Pakistan Blue Health Full time 400,000 - 800,000 per year

Blue Health is seeking a Prior Authorization Specialist a
non Clinical role
(also known as Clinical Authorization Coordinator) with a medical or allied health science background for a non-clinical role supporting our prior authorization process.
(Students are encouraged to apply)
This position combines healthcare expertise with cutting-edge technology and offers a dynamic, innovation-driven environment modeled on US healthcare standards.

Key responsibilities:

  • Review prior authorization requests for medical services, procedures, and prescriptions.
  • Apply clinical knowledge and payer guidelines to assess medical necessity.
  • Ensure compliance with HIPAA and payer-specific requirements.
  • Coordinate with physicians, pharmacists, and healthcare providers to obtain supporting documentation.
  • Maintain accurate case records in EHR/EMR systems.
  • Support appeals and denials management when required.
  • Leverage AI-based tools to streamline authorization workflows and improve decision-making efficiency.

Requirements:

  • Background in Nursing, Pharmacy, or Allied Health Sciences (RN, LPN, BSN, PharmD, CPhT, or equivalent).
  • Strong understanding of medical terminology and payer guidelines.
  • Prior experience in utilization management, authorization, or clinical review is highly preferred.
  • Excellent communication, organizational, and analytical skills with attention to detail.

Qualifications:

  • Bachelor's degree in Nursing, Pharmacy, Allied Health, or equivalent clinical field.
  • Preferred: MBBS, DPT, or PharmD.
  • Ability to work independently in a fast-paced, tech-enabled environment.
  • Familiarity with EHR/EMR systems and insurance workflows.

Why Blue health:

  • Exposure to cutting-edge AI tools that enhance efficiency, learning, and communication.
  • At Blue Health, your accent naturally improves through regular communication practice, supporting success in international healthcare language exams.
  • Professional connections and internship opportunities in the US healthcare system.
  • A culture that rewards innovation, encourages creative development, and recognizes individual contribution.
  • No-boss culture work in a flat, collaborative structure focused on mentorship and growth.
  • Experience a US-style work environment blending healthcare operations and continuous learning.

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