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.
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.
Support pharmacy benefit operations by coordinating clinical and administrative workflows.
Review documentation and communicate with members, providers, and internal stakeholders.
Ensure accurate and compliant processing of pharmacy benefit requests.
We are an innovative company striving to reduce the cost of healthcare. We have a tight-knit culture based on an outward mindset and are growing quickly.
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.
Lead strategic growth and operational management of pharmacy benefit and managed care relationships nationwide.
Oversee contract evaluation, negotiation, implementation, and renewal with major healthcare payers.
Analyze reimbursement trends and contract performance to support revenue optimization and business growth.
This company operates in the specialty pharmacy sector, supporting patients with chronic and rare illnesses. It is a mission-driven, rapidly growing environment focused on improving access, care, and outcomes for patients with complex healthcare needs.
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.
Lead a multidisciplinary team integrating QA oversight, technical system management, and medication policy execution.
Drive clinical strategy, prior authorization platform management, and data-driven process improvements.
Ensure safety, evidence-based compliance, and operational excellence across the PA ecosystem.
SmithRx is a venture-backed Health-Tech company disrupting the Pharmacy Benefit Management (PBM) sector with a next-generation drug acquisition platform. With hundreds of thousands of members onboarded since 2016, the company is guided by a mission-driven and collaborative culture that inspires employees to transform the U.S. healthcare system.
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.
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.
Provide clear, empathetic assistance to members regarding pharmacy benefits and medication access.
Resolve complex issues by collaborating with cross-functional teams and handling sensitive cases.
Document all interactions accurately and adhere to HIPAA and privacy policies.
The OccuNet Company is an innovative company striving to reduce the cost of healthcare. They have a tight-knit culture based on outward mindset and are growing quickly.
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.
Assist patients with enrolling in our Prescription Payment Plan and verifying eligibility.
Coordinate with pharmacies to apply benefits and reduce out-of-pocket costs.
Guide patients through renewals and updates to ensure continued access.
We are a team dedicated to improving access to affordable prescription medications for patients. We partner with insurance companies, healthcare providers, and pharmacies to reduce the financial burden of medications, ensuring patients can access treatments without excessive costs.
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.
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.
Oversee the administration, compliance, and audit readiness of the 340B Drug Pricing Program for assigned Covered Entity clients.
Serve as the primary compliance resource, conducting routine reviews, internal audits, and operational assessments to identify risks.
Collaborate with clients, internal teams, and third-party administrators to ensure compliant and effective program operations.
NuvemRx helps community health providers simplify pharmacy operations with a suite of scalable solutions integrating software, intelligence, and expert support. We are a fast-growing, mission-driven team that values integrity, collaboration, and a bias toward action.
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.
Provide clinical expertise in neurology and behavioral health across the system.
Develop and implement evidence-based guidelines, policies, and procedures.
Collaborate with healthcare teams to enhance medication use and patient outcomes.
Baptist Health is a full-spectrum health system based in Louisville, Kentucky, operating 10 hospitals and more than 470 points of care. With over 24,000 employees and a strong focus on clinical excellence and nursing recognition, it is dedicated to improving community health.
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.