Perform patient-specific medication reviews and develop recommendations for medical drug utilization management and Medication Therapy Management.
Resolve medication and pharmacy issues for members triaged from Member Services or other departments.
Act as subject matter expert for audits, quality improvement, and LEAN projects.
IEHP is a not-for-profit health plan dedicated to healing and inspiring the human spirit by providing quality healthcare services to members. They emphasize a supportive culture with career growth and wellness programs for their team.
Verify prescriptions and conduct drug utilization reviews to ensure regulatory compliance.
Review Prior Authorization requests and transfer prescriptions for timely medication delivery.
Collaborate across departments to improve patient health outcomes and adherence.
PHIL is a San Francisco-based health-tech startup building a platform that connects doctors, pharmacies, and patients to streamline prescription management and delivery. The team consists of mission-driven individuals from diverse backgrounds focused on creating an innovative healthcare platform.
Provide integrated support to patients and physicians to improve medication adherence and quality of care.
Review patient assessments and EMRs to develop care plans and optimize drug therapies.
Monitor adherence, oversee technicians, and ensure compliance with pharmacy regulations.
Shields Health Solutions provides integrated specialty pharmacy support to patients and physicians. The company emphasizes high-integrity, quality-focused teamwork and confidentiality in a remote work environment.
Provide clinical expertise and strategic recommendations to clients and internal teams on drug spend, formulary compliance, and clinical programs.
Act as a clinical liaison between Plan Operations and other departments, communicating formulary changes and program updates.
Analyze drug benefit designs, prepare clinical marketing materials, and support go-live activities for new client groups.
SmithRx is a venture-backed health-tech company disrupting the PBM sector with a next-generation drug acquisition platform. It has hundreds of thousands of members and a mission-driven, collaborative culture guided by integrity, courage, and togetherness.
Manage formularies, coverage determinations, and benefit design for PBM services.
Resolve clinical inquiries from members, clients, providers, and pharmacies.
Support P&T Committees with drug monographs, summaries, and medication policies.
OHSU is Oregon's only public academic health center with hospitals, clinics, and research schools. It is Portland's largest employer and a national research hub, welcoming diverse backgrounds.
Review and process prior authorization requests for various medications.
Communicate prior authorization criteria to providers and act as a help desk.
Process requests via phone, fax, and web submission while maintaining HIPAA compliance.
Lumicera Health Services is a specialty pharmacy focused on optimizing patient well-being through transparency and stewardship. It fosters a diverse and creative work environment as part of the Navitus organization.
Review, process, and troubleshoot incoming Prior Authorization requests for various medications.
Accurately process requests according to regulatory and client-specific guidelines while meeting departmental performance metrics.
Work with clinical teams and handle requests via phone, fax, and web submission.
Navitus is a pharmacy benefit manager (PBM) alternative focused on reducing drug costs to make medications more affordable. The company offers a diverse and creative work environment with numerous employee benefits and growth opportunities.
Serve as the designated Pharmacist-in-Charge, reviewing licensing submissions and regulatory documentation.
Work with pharmacy operations and compliance team to support ongoing compliance and Board-related discussions.
Provide professional guidance and identify issues requiring follow-up or corrective action.
MD Exam is a growing healthcare organization with established sterile compounding operations. It offers an experienced team support and a collaborative culture focused on patient safety and compliance.
Serve as the designated Pharmacist in Charge and fulfill all related responsibilities.
Review and approve licensing submissions, renewals, and regulatory documentation.
Collaborate with the operations and compliance team to support ongoing compliance.
MD Exam is a healthcare organization specializing in sterile compounding operations. They are a growing company with an experienced team dedicated to compliance and patient safety.
Verify prescriptions for therapeutic appropriateness, interactions, and dosing accuracy.
Provide proactive phone-based patient counseling and handle inbound clinical calls.
Collaborate with prescribers and supervise pharmacy technicians to maintain workflow quality.
Blink Health is a healthcare technology company that builds products to make prescriptions accessible and affordable, with a focus on removing roadblocks in the prescription supply chain. They are a collaborative team of builders and operators who value innovation and diversity.
Supervises representatives, manages performance, and provides feedback through side-by-side and recorded call reviews.
Handles escalated calls, partners with business units, and coordinates team schedules to maximize efficiency.
Monitors volumes for pending queues and ensures timely processing of prior authorization forms.
PharMerica is a long-term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States. It operates as part of BrightSpring Health Services, combining personalized care with the resources of a national network.
Processes electronic medication refill requests and communicates with providers and patients.
Ensures compliance with all HIPAA regulations and maintains patient confidentiality.
Provides excellent customer service and assists with prior authorization and medication assistance guidance.
St. Elizabeth Healthcare provides medical services as one of the largest healthcare providers in the Northern Kentucky region. The organization emphasizes a culture of caring for patients and each other, with a focus on innovation and community.
Support Pharmacists and patients by conducting medication reviews and optimizing prescription drug therapy.
Make outbound calls and take inbound calls to collect medication history and provide counseling.
Work remotely with a flexible schedule within EST business hours and participate in training with camera on.
Humana is a leading U.S. healthcare company that provides insurance and healthcare services to millions. With a large workforce, Humana fosters a caring community and supports career growth.
Manage, triage, and assign clinical pharmacy referrals to the appropriate clinical pharmacy team member.
Schedule patient/caregiver appointments and prepare charts for pharmacist-driven clinical programs.
Communicate with pharmacies, insurance companies, and internal teams to resolve medication access barriers.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs, delivering 24/7 virtual-first and in-home medical, behavioral, and social care. The company is guided by values like Children First, Earn Trust, and Embrace Humanity, fostering a culture of empathy, innovation, and diverse perspectives.
Manage prescription workflows and provide clinical and operational support to the pharmacy enablement team.
Collaborate with RNs, providers, and coaches to coordinate care and resolve member issues.
Process clinical tickets, route faxes and records, and follow SOPs to maintain compliance.
Virta Health works to reverse metabolic disease in one billion people using technology, personalized nutrition, and virtual care delivery. It is a remote-first company backed by over $350 million from top-tier investors, partnering with health plans, employers, and government organizations.
Provide exceptional phone-based customer service and process prescriptions with speed and accuracy.
Perform claim adjudication, billing, and eligibility checks while maintaining detailed patient records.
Act as a liaison between pharmacists and medical professionals, placing outbound calls to support patient care.
AnewHealth is a leading pharmacy care management company specializing in complex, chronic patient care. With over 1,400 team members and an award-winning culture, we serve more than 100,000 people across all 50 states.