Leads non-clinical administration of pharmacy utilization management programs, processing prior authorization requests and ensuring compliance with workflows and regulations.
Serves as a subject matter expert, overseeing workflow coordination, training, quality oversight, and resolution of non-clinical escalations.
Acts as a super-user for UM technology, leading operational configuration, testing, and process improvements.
Oversee daily clinical pharmacy functions including prior authorization reviews, override requests, and member/provider education calls.
Support staff training, quality improvement, and lead projects to optimize pharmacy operations and clinical outcomes.
Serve as a subject matter expert and make clinical decisions based on medical necessity and contract criteria.
Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. It replaces fragmented systems with a unified claims processing platform and uses AI-powered care delivery to serve millions of Americans, fostering a mission-driven, collaborative culture.
Lead and support patient engagement specialists, providing oversight, coaching, and workflow guidance.
Manage clinic implementation, stabilization, and queue prioritization to ensure high-quality patient care.
Maintain patient engagement specialist duties and act as subject matter expert on SOPs and compliance.
Shields Health Solutions provides specialty pharmacy care and patient engagement services, partnering with health systems to support medication adherence. The company fosters a collaborative, data-driven team culture focused on high-quality patient service and professional growth.
Lead end-to-end client onboarding and technical implementations to drive project completion.
Configure EMR platforms, HubSpot accounts, and webhooks while troubleshooting issues.
Deliver virtual training and collaborate with Sales and Customer Success teams.
Strive Pharmacy is a personalized compounding pharmacy that believes medicine should fit the patient. They are a growing team focused on disrupting the pharmaceutical industry with a human-centered approach.
Manage prior authorization requests and coordinate specialty medication processes for a fully remote healthcare team.
Act as a liaison between pharmacies, prescribers, members, and vendors to resolve complex medication-related issues.
Support single case agreements, member financial assistance, and compliance with contractual and regulatory requirements.
The hiring company is a healthcare organization that administers specialty pharmacy and medical benefit programs. It operates fully remotely, fostering a collaborative and customer-focused culture that prioritizes compliance, member support, and process improvement.