Source Job

• Oversee daily operations related to patient medication refill administration and inbound pharmacy patient inquiries.
• Manage clinic level and/or hospital service level escalations; build and action plan for resolution.
• Work with leadership to develop documented staffing plans and staffing forecasts that align with the needs of the region and productivity targets.

Shields Health Solutions is a fast-growing company in the specialty pharmacy management services.

• 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.

• Support the AVP of Medical Cost Containment in the implementation, process improvement, and optimization of clinical programs.
• Manage a team of 8 pharmacists through a remote setting, overseeing a countrywide prior authorization program specific to workers compensation claims.
• Monitor, analyze, and trend clinical program data to assist in the development, implementation, and driving of key initiatives.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected.

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.

• Lead and oversee Prior Authorization Operations across all lines of business.
• Manage Prior Authorization processes ensuring optimal efficiency and compliance.
• Drive cross-functional collaboration to align with organizational goals.

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They are rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.

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.

Centene is committed to helping people live healthier lives by providing access to high-quality healthcare, innovative programs and a wide range of health solutions.

• 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.

• Owns end to end operations and expansions for our provider networks in the US & Canada.
• Deeply understand and elevate Carrot’s strategic positioning within the US & Canada healthcare and provider ecosystems.
• Define and deliver on KPIs related to provider network operations response including establishing goals, methodology on measurement/tracking, and execution.

Carrot is a global, comprehensive fertility and family care platform, supporting members and their families through life's memorable moments. They are trusted by multinational employers and health plans, offering localized support in over 170 countries and 25 languages.

• Collaborate with suppliers to identify and mitigate potential supply chain issues.
• Serve as a point of contact for day-to-day matters and regular business reviews.
• Develop relevant internal and external SOPs to reflect market best practice.

Blink Health is a healthcare technology company focused on making prescriptions accessible and affordable. They're a collaborative team that invents new ways of working in an industry that has historically resisted innovation.

• Oversee operational and clinical performance of contracted provider partners.
• Drive execution on economic, clinical, and population health strategies.
• Proactively analyze population health data to identify opportunities for improvement.

Apree Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. They seem to have a fast-paced evolving environment.

• Conduct regular one-on-ones, performance reviews, and development planning.
• Act as the primary escalation point for member issues and complex fertility-related financial and billing issues.
• Use your continuous improvement mindset to define and iterate on processes, making positive enhancements to drive efficiency, value, and accountability toward KPIs.

Maven Clinic is the world's largest virtual clinic for women and families, aiming to make healthcare work for everyone. The company has over 2,000 employers and health plans trusting their platform, and they've won multiple awards for their culture and innovation.

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.

• Review and audit prescriptions and delivery slips for completion and accuracy.
• Collaborate with clinicians in specialty clinics to ensure seamless medication management and adherence.
• Educate patients on how pharmacy services enhance care and improve outcomes.

Shields Health Solutions is a fast-growing leader in specialty pharmacy management services, dedicated to making a real difference in patients’ lives.

• 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.

• Lead a team to generate and post Physician and APP schedules across all sites of care, maximizing efficiency and meeting operational goals.
• Identify and execute opportunities to improve clinical quality and reduce costs through enhanced scheduling.
• Collaborate with technology and scheduling leaders to enhance tools and share best practices.

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements.

Provide oversight of assigned clients, including implementation and ongoing management. Understand client needs and ensure deliverables meet expectations and KPIs. Triage and respond to medical information inquiries from healthcare professionals, consumers, and payers.

EVERSANA is committed to creating and delivering next-generation commercialization services to the life sciences industry with over 7,000 employees.

Lead and develop a high-performing Intake team, ensuring operational metrics, quality standards, and regulatory requirements are met. Oversee daily intake operations, coach team members, and drive performance through clear communication and accountability. Reinforce standardized processes, mitigate compliance risks, and support operational excellence to strengthen client trust and organizational growth.

Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration.