Manage end-to-end patient access case activities including benefit verification, prior authorization, appeals, and pharmacy coordination.
Apply pharmacy technician knowledge to review prescriptions, identify barriers, and coordinate with providers, payors, and pharmacies.
Maintain accurate case documentation and communicate effectively with patients, healthcare professionals, and internal teams.
PRO-spectus is a patient services company that strategically navigates the patient access process from prescription intake through treatment initiation. The company fosters a supportive, teamwork-driven culture with a focus on improving patient lives, though its exact size is not specified.
Facilitate medication approvals by communicating with insurance companies and healthcare providers regarding prior authorizations.
Navigate pharmacy systems to enter data, adjudicate claims, process refills, and document patient interactions.
Assist patients with insurance claims, medication access challenges, and promote adherence through phone support.
Shields Health Solutions is a healthcare company dedicated to helping patients access life-changing medications through prior authorization and financial assistance support. They foster a collaborative, patient-focused culture with opportunities for professional growth in a fully remote setting.
Coordinate and process medication refills including data entry and claim adjudication.
Place outbound refill calls and assist patients through the refill request process.
Respond to and resolve inbound patient and provider inquiries with empathy.
Shields Health Solutions partners with health systems to deliver specialty pharmacy care. They foster a supportive culture with employee resource groups and wellness programs.
Communicate with insurance companies and clinician offices to facilitate medication prior authorizations.
Assist patients with financial assistance resources and navigate pharmacy systems for claims processing.
Support medication adherence through direct patient communication and accurate documentation.
Shields Health Solutions is a healthcare solutions company specializing in specialty pharmacy services. The company fosters a collaborative culture focused on patient care and operational excellence.
Assist members, providers, and internal teams in navigating prescription coverage and prior authorization requests.
Verify eligibility, drug coverage, and perform claims adjudication based on plan benefit design.
Triage and prioritize multiple requests, coordinate outreach, and make determinations under protocol.
SmithRx is a health-tech company disrupting the pharmacy benefit management industry with a next-generation drug acquisition platform. With hundreds of thousands of members, they have a mission-driven and collaborative culture guided by values of integrity, courage, and together.
Triage incoming clinical programs calls, schedule consultations, and conduct outreach to prescribers, pharmacies, and members.
Manage and maintain drug lists to support clinical programs, including periodic maintenance and ad-hoc updates.
Support reporting requirements, monitor claims, and ensure communication among internal and external stakeholders.
Judi Health is a health technology company providing benefit administration solutions with Unified Claims Processing architecture. It operates in a startup environment, deploying infrastructure for millions of Americans.
Lead and manage a team of Patient Support Associates to ensure medication adherence through refill management or timely prior authorization and financial assistance.
Manage service level goals, conduct audits, and provide coaching and performance management for a remote Patient Support team.
Collaborate with on-site management at hospital partners for quarterly calls, workflow improvements, and record keeping.
Shields Health Solutions provides specialty pharmacy management services to healthcare organizations. They are a fast-growing company with a close-knit team that values employee development and high-quality patient care.
Answer new referral intake and refill calls in a timely and professional manner, accurately updating patient information in the computer system.
Contact patients to collect information for medical chart establishment and schedule delivery or shipping arrangements for refills.
Maintain accurate patient records, assist with copay collections, and participate in performance improvement and quality management processes.
VytlOne is a specialty pharmacy company transforming the pharmacy industry through purposeful engagement across Pharmacy Benefit Management, Pharmacy Management, Specialty Pharmacy, and more. They foster a diverse and progressive culture with a remote work model and a team-oriented environment that encourages collaboration and innovation.
Support the Pharmacotherapy Clinic by assisting pharmacists with patient communication and care coordination.
Conduct patient check-ins, coordinate appointments, and track labs to ensure timely follow-up.
Maintain documentation in Epic and perform clerical tasks to support clinical operations.
Shields Health Solutions provides specialty pharmacy services to health systems and hospitals. They focus on patient-centered care and offer a collaborative, inclusive work environment.
Answer inbound and outbound calls to schedule and complete medication refills for patients.
Work closely with pharmacists, providers, and care teams to resolve prescription and claim issues.
Maintain accurate patient records and provide friendly, helpful support throughout the refill process.
Shields Health Solutions helps patients manage their medications by connecting them with pharmacy care teams. The company is a growing health solutions provider that values dependability, organization, and patient-focused support.
Serve as a point of contact for patients, families, and healthcare providers to address medication-related problems and answer pharmacotherapy questions.
Ensure accurate, efficient, and compliant medication distribution and fulfillment using proprietary software, including proper documentation and billing.
Oversee pharmacy technicians, review prescriptions, and maintain compliance with state and federal regulations, including HIPAA and quality standards.
AnewHealth is a leading pharmacy care management company specializing in caring for people with complex, chronic needs. With over 1,400 team members, the company was established in 2023 through the combination of ExactCare and Tabula Rasa HealthCare and serves more than 100,000 people across all 50 states.
Provides comprehensive medication management and patient counseling through telephone consultations.
Completes medication reviews to ensure safety, efficacy, and cost-effectiveness.
Collaborates with healthcare professionals to optimize therapeutic outcomes.
Dartmouth Health is a nonprofit academic health system delivering advanced medical care and research. It is one of New England's largest employers with a culture that values innovation and teamwork.
Manage medication therapy for high-risk patients with chronic conditions using evidence-based protocols.
Collaborate with physicians, nurses, and specialists to optimize treatment plans during high-risk rounds.
Conduct patient education and in-service sessions to promote medication safety and quality care.
CenterWell Senior Primary Care provides proactive, preventive care to seniors, focusing on personalized experiences and whole-person health. As part of Humana, a large healthcare company, we foster a caring community that prioritizes employee well-being with competitive benefits.
Act as a trusted liaison between patients and healthcare providers, providing expert guidance on pharmacy benefits.
Own patient cases end-to-end, resolving coverage, prior authorization, and appeals issues.
Collaborate with stakeholders to ensure members navigate the healthcare system with confidence.
AffirmedRx is a pharmacy benefit management company on a mission to improve healthcare outcomes by bringing clarity, integrity, and trust to the industry. They are a mission-driven organization committed to patient-centered care and ethical practices.
Make outbound calls to eligible patients to enroll them in the Shields Partner Pharmacy program and explain the benefits of the service.
Access patient EMR and review chart notes to ensure familiarity with their condition before each call.
Identify medications requiring special handling and necessary supplies such as sharps containers or needles.
Shields Health Solutions is a specialty pharmacy services company that partners with health systems to provide comprehensive pharmacy care. They offer a supportive culture with benefits starting day one and opportunities for professional development.
Serve as a primary contact for medication inquiries, triaging calls and portal messages with empathy and urgency.
Facilitate prior authorizations and coordinate follow-up appointments to ensure continuity of care.
Document all interactions using SBAR standards and educate patients on refill policies and adherence.
Mindpath Health is redefining how mental health care is delivered, operating in more than 100 locations across six states with in-person and telehealth services. The team is deeply committed to compassionate, collaborative care and values diversity and inclusion.
Support patients by managing prescription refill requests and authorizing renewals based on standing orders.
Receive and triage refill requests from pharmacies and patients, reducing provider time spent on refills.
Communicate effectively with physicians and patients, ensuring consistent turnaround and adherence to care plans.
Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation providing comprehensive health care services. As an affiliate of one of the largest health systems in the nation, they offer purposeful work settings where staff can advance through challenging assignments.
Triage clinical incoming calls and conduct outreach to members, pharmacies, and prescribers.
Support operations of clinical programs including pharmacogenomics, MTM, and lower cost alternatives.
Ensure customer satisfaction and meet performance metrics while maintaining quality and compliance.
Judi Health is a health technology company providing benefit administration solutions to employers, unions, and health plans, using a unified claims processing platform. The company focuses on transparency and efficiency, serving millions of Americans.
Develop and maintain protocols for prescribing, dispensing, and administering medications.
Provide specialized services to help patients manage chronic conditions such as Diabetes, COPD, and Hypertension.
Collaborate with healthcare professionals to plan, monitor, and evaluate patient effectiveness and medication safety.
Better Health Group is a healthcare organization dedicated to improving patient health through comprehensive medication management services. It is a growing team that values commitment, passion, and a culture of support for both employees and patients.
Review and evaluate medication orders for accuracy, appropriateness, and safety.
Provide medication counseling to patients, addressing questions and concerns.
Collaborate with healthcare providers to develop and monitor medication therapy plans.
Shields Health Solutions provides pharmaceutical care services, specializing in therapy management programs for patients with conditions like diabetes and weight management. The company focuses on remote collaboration with healthcare professionals to ensure safe and effective medication therapies.