Communicate with patients and explain the Shields Partner Pharmacy program.
Access patient's EMR and review chart notes prior to outbound calls.
Identify medications requiring special storage and necessary supplies.
Shields Health Solutions proactively grows the specialty pharmacy patient population. They provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type.
Directly communicate with insurance companies to facilitate the approval of medications.
Navigate pharmacy operating systems to input data and prepare action plans for follow-up.
Communicate directly with patients over the phone to assist them in medication compliance.
Shields Health Solutions provides integrated pharmacy solutions. They partner with hospitals and health systems to improve patient outcomes and create financial value.
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.
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.
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.
Collaborate with providers to individualize drug therapies promoting safe, effective and economical patient care.
Assume responsibility for monitoring and modifying the drug regimen when referred, to include the ordering and interpretation of laboratory testing.
Act as a drug information resource to providers, nursing staff, research staff and patients.
Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. They operate eight clinical care sites and have a reputation as one of the world’s leading biomedical research centers.
Complete monthly utilization management and appeals performance and process audits.
Present audit results to leadership to address issues.
Assist management in identifying, evaluating, and mitigating risks.
Judi Health provides a comprehensive suite of solutions for employers and health plans. They offer full-service health benefit management solutions and consolidate all claim administration-related workflows in one scalable, secure platform.
Provide health assessments and treatment solutions via telephone, video, or chat functions.
Track and monitor follow-up calls, escalate when appropriate.
Receive inbound phone calls from patients seeking answers to various medical conditions.
PWNHealth is a national clinician network working to improve early detection and prevention of disease using advanced diagnostics and telehealth. They are a mission-driven, positive culture made up of the best and brightest in the industry.