Supports the clinical team through collaboration with prescribers and beneficiaries. Provides medication therapy management (MTM) services via triage of inbound calls. Documents services/activities in appropriate databases/software to ensure compliance.
Provide integrated support to patients and physicians, taking a hands-on approach to improve patient care quality.
Develop personalized relationships with patients and prescribers to enhance medication adherence and promote evidence-based care.
Monitor patient adherence across sites and disease categories, focusing on oncology and other specialty-specific conditions.
Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment.
Provide one-on-one counseling to patients and caregivers on medication use, adherence, side effects, and cost-effective options.
Conduct comprehensive medication reviews and reconciliation, particularly for patients with chronic conditions, multiple medications, or recent hospitalizations.
Partner with care managers, health center pharmacists, and primary care providers to support patients in meeting treatment goals, including diabetes, hypertension, COPD, and other chronic conditions.
Medical Home Network (MHN) partners with Federally Qualified Health Centers (FQHCs) nationwide to transform care. They help FQHCs succeed in value-based care through technology, care model innovation, and strong partnerships, expanding reach to enhance care for their patients.
Lead, coach, and develop Team Leads and Member Services Associates.
Own performance outcomes for medication access including resolution time, pharmacy turnaround, quality scores, and member satisfaction.
Serve as the primary operational partner for pharmacy vendors, owning escalation patterns, performance issues, and workflow alignment.
Maven is the world's largest virtual clinic for women and families with a mission to make healthcare work for all. They have raised more than $425 million in funding and have been recognized as a Time 100 Most Influential Company and a Fast Company Most Innovative Company.
Oversees daily operations in the specialty pharmacy call center.
Leads workflow optimization and staff professional development through direct supervision.
Assists with execution of strategic initiatives pertaining to call center specialty pharmacy operations.
Founded in 1924 in Louisville, Kentucky, Baptist Health is a full-spectrum health system dedicated to improving the health of the communities it serves.
Evaluate patient data in Arine’s software platform and prepare reports concerning patient care and team progress.
Complete efficient medication reviews and counseling appointments.
Develop intervention strategies to optimize medication utilization and achieve quality measures.
Arine is a rapidly growing healthcare technology and clinical services company with a mission to ensure individuals receive the safest and most effective treatments.
Provide medication management for individuals, including medication reconciliation, dose optimization, and medication adherence counseling. Collaborate with the interdisciplinary care team to develop individualized care plans that align with evidence-based guidelines. Monitor and evaluate medication regimens to ensure clinical criteria are met, including therapeutic goals, adverse effects, and drug interactions.
Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type.
Evaluate and review all appeals requests to render coverage determinations based on clinical criteria and medical necessity.
Perform scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to providers.
Make clinical prior authorization determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times.
Judi Health offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi® the industry’s leading proprietary Enterprise Health Platform (EHP). Together with our clients, they’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.
Oversee a team of pharmacy technicians in the prior authorization process. Analyze data and provide recommendations to maximize team agility and performance. Generate and deliver reports on technician metrics to stakeholders.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans.
Answers calls and route all incoming correspondence to appropriate staff.
Maintains up to date patient health records in the Electronic Medical Record system and Vynca data systems.
Coordinates transportation for patient medical appointments with contracted transportation companies and payers.
Vynca is passionate about transforming care for individuals with complex needs and is focused on providing comprehensive care for more quality days at home.
Provide utilization management services, transition of care, and support to members and health care providers.
Utilize clinical knowledge to interpret medical policy and provide consultation on UM requests.
Proactively assess and assist members through the continuum of care by utilizing services and resources efficiently.
Wellmark is a mutual insurance company owned by its policy holders across Iowa and South Dakota, and it has built its reputation on over 80 years of trust.
Maintain full ownership and accountability for initiating phone contact to potential study participants.
Conduct phone-based pre-screening interviews for potential study participants to determine pre-qualification status and eligibility for onsite screening visits.
Input and record patient information and call notes into CTMS database and other portals and systems in compliance with standardized patient enrollment processes and procedures.
M3 Wake Research is an integrated network of premier investigational sites meeting the clinical research needs of global biopharmaceutical organizations.
Provides integrated off-site support to patients, pharmacists, and providers for total quality patient care.
Delivers medication adherence support utilizing various tools and applications.
Educates prospective pharmacy patients on how the hospital pharmacy improves their overall care.
Shields Health Solutions partners with hospitals to build and manage specialty pharmacies within their systems. They aim to improve medication access, adherence, and outcomes for patients with chronic conditions.