Respond to patient inquiries regarding prescription drug plan coverage and fulfillment through the pharmacy, including answering inbound calls and conducting status checks.
Make outbound patient refill phone calls, coordinate medication refills including data entry and pharmacy claim adjudication, and resolve adjudication error messages.
Manage, organize, and update relevant data using database applications, identify trends, and participate in process improvement initiatives.
Review and process patients’ enrollment forms for the Patient Assistance Program.
Assist patients on the phone with PAP program enrollment by verifying pre-screening and qualifying tasks.
Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process.
CareTria aims to help patients access coverage for their prescribed medications. We provide telephone support and administrative functions. The company offers comprehensive benefits and is an Equal Opportunity Employer, indicating a commitment to a positive and inclusive work environment.
Responsible for aiding in the delivery of clinical interventions and Medication Therapy Management (MTM) services for commercial and Medicare members.
Conducts telephonic and video chat outreach to complete analysis of members' medication regimens.
Performs outbound calls to members, fielding inbound calls, and facilitating communication regarding clinical programs.
Navitus is an alternative to traditional pharmacy benefit manager (PBM) models, committed to removing cost from the drug supply chain to make medications more affordable. The company has a team that celebrates diversity, fosters creativity, and encourages growth.
Contact physician offices for refill authorizations and verify orders.
Process new and refill prescriptions, ensuring accurate data entry and maintaining productivity.
Answer incoming calls promptly and provide high standard of customer service.
Symbria Rx Services is a 100% employee-owned healthcare company that provides patient-centered care to the geriatric population in senior-living and post-acute settings. For over 20 years, they have been delivering an outstanding work environment for talented employees.
Process referrals to MTM team and schedule appointments for patients.
Provide phone support and document patient information in electronic health records.
Assist with prior authorizations and billing to help patients access affordable medications.
UnityPoint Health is a healthcare system providing medical services. It is recognized as a Top 150 Place to Work in Healthcare and offers a supportive culture for team members.
Serve as primary point of contact for specialty pharmacy patients from enrollment through therapy adherence, handling benefits verification and prior authorization.
Manage a caseload independently, perform outbound calls, and coordinate with pharmacy partners to ensure accurate therapy and shipment status.
Maintain strict patient confidentiality per HIPAA, recognize and report adverse events, and follow program-specific protocols.
Caretria provides patient support services for specialty pharmacy patients, focusing on enrollment, benefits verification, and care coordination. The company values empathy, urgency, and accuracy, and offers a comprehensive benefits package to its employees.
Reviews Part D coverage determinations and appeals to ensure clinical appropriateness and compliance with CMS regulations.
Conducts Medication Therapy Management (MTM) activities, including comprehensive medication reviews and targeted interventions for high-risk members.
Supports pharmacy quality improvement initiatives aligned with Medicare Star Ratings and HEDIS measures.
Alignment Health is a healthcare company focused on serving seniors and the chronically ill through Medicare Advantage plans. The company is fast-growing with a team of passionate people dedicated to transforming senior care.
Completes telephonic outreach to engage and schedule patients for health assessments.
Maintains call targets and metrics to ensure program success and volume goals are met.
Provides patient education and coordinates appointments and resources as needed.
Lumeris empowers value-based care, making healthcare safer, more affordable and personalized for providers, patients, and payers. The company is an EEO/AA employer with a focus on growth and employee engagement in a fast-paced environment.
Directly lead and manage a team of Patient Support Associates to ensure medication adherence or timely prior authorization.
Proactively manage support in assigned hospitals and/or clinics to ensure patients receive medications on-time.
Provide front-line supervision and ongoing coaching and performance management to Patient Support team.
Shields Health Solutions is a specialty pharmacy management service provider. They are a fast-growing company that values motivated self-starters with a positive outlook and a focus on high-quality work.
Lead and manage a team of Patient Support Associates, providing coaching and performance development.
Ensure medication access through refills, prior authorizations, and financial assistance.
Oversee pharmacy workflows, conduct system audits, and collaborate with hospital stakeholders.
Shields Health Solutions specializes in specialty pharmacy services and patient support for hospitals and clinics. The company fosters a culture of patient-focused care and team collaboration, with a remote and onsite workforce.
Serve as a primary contact for incoming DME referrals, providing clear information on pricing, order status, timelines, and qualification requirements.
Advance referrals by reviewing documentation, identifying gaps, and securing clinical or insurance information.
Verify insurance eligibility, maintain patient accounts, and coordinate intake workflows across multiple communication channels.
CarepathRx advances pharmacy and care delivery alongside hospitals and health systems nationwide. The team is ambitious, compassionate, and invested in curious, resilient individuals who are motivated to grow, keeping patients at the heart of everything they do.
Review appeals for commercial and Part D plans, rendering determinations based on clinical guidelines and regulatory requirements.
Serve as a clinical reviewer and subject matter support, performing independent research and retrospective case reviews.
Assist with CMS client audits, investigate appeal determination questions, and support clinical training activities.
MedImpact delivers leading edge pharmaceutical and technology related solutions that improve the value of healthcare, providing transparency and choice. Privately-held for over three decades, it is one of the leading pharmacy benefit managers in America, committed to making prescription benefits understandable and accessible.
Collect and document clinical information from providers, pharmacies, and members.
Assist pharmacists with utilization management and appeals processing.
Communicate with prescribers and pharmacies regarding authorization status and coverage requirements.
The OccuNet Company is an innovative company striving to reduce the cost of healthcare through negotiations-driven levers and an experience-centric approach. We have an ambitious vision and are growing quickly, with a tight-knit culture based on the outward mindset philosophy emphasizing empathy and mutual respect.
Provide patient care and advanced clinical pharmacy services in the ambulatory pharmacy space.
Collaborate with prescribers and manage medication therapy for direct patient care.
Document patient interactions across various electronic medical record platforms.
Saint Francis Hospital is a healthcare facility in Chicago, IL, part of Prime Healthcare SFIL Resurrection Medical Center. It offers a comprehensive benefits package and empowers staff with resources for growth and well-being.
Perform remote order entry and CPOE evaluation and verification for acute-care hospitals.
Utilize clinical skills including monitoring, dosing, and reviewing patient medication therapy.
Collaborate with physicians and nurses to ensure continuity of care and regulatory compliance.
Cardinal Health distributes pharmaceuticals and provides medical products and data solutions for healthcare facilities. With over 45 years of experience, it is one of the largest employers of acute-care pharmacists in the United States, fostering an inclusive workplace that values diversity.