Provide expert-level medication therapy consultations to patients and providers, including Medication Therapy Management (MTM) services like Comprehensive Medication Reviews (CMRs) and Targeted Medication Reviews (TMRs).
Collaborate with the Engineering team and leadership to improve Arine's software platform and guide the Clinical Support team, while managing a consistent volume of patient interactions.
Meet individual and team performance metrics related to outreach, engagement, documentation quality, and clinical outcomes, and adapt to evolving clinical projects and assignments.
Arine is a rapidly growing healthcare technology and clinical services company that uses data science and AI to optimize medication management and reduce healthcare costs. The company manages over 18 million lives, was ranked #236 on the 2024 Inc. 5000 list, and has a strong culture focused on innovation and patient outcomes.
Function in the Medication Support Navigator - Care Coordinator role supporting both regions and the Medication Navigator team.
Ensure timely completion of referrals and supports Medication Support Navigator team in timely completion.
Direct people leadership of the Medication Support Navigator team including 1:1s and performance management.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care, working alongside families, providers, and health plans.
Assists RedBox Rx patients via phone, chat and email.
Perform drug utilization review and pre-verification of prescriptions.
Provides counseling to RedBox Rx patients in accordance with all state and federal statutes and regulations.
Hy-Vee's people are its strength, promising "a helpful smile in every aisle." They aim for a fully engaged and committed workforce supporting customers and each other.
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.
Coordinate care between physicians, patients, and pharmacies to facilitate access to specialty medications for complex disease states.
Review chart notes and perform utilization management, handling case assignments and documenting case progress.
Provide clinical expertise to prescribers and guide prescribing offices through the prior authorization process.
Archimedes is the industry leader in specialty drug management solutions, transforming the PBM industry to provide alignment, value, and transparency. The company achieves superior results for clients by eliminating conflicts of interest and delivering rigorous clinical management at the lowest net cost.
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.
Accurately and timely review medication orders in a virtual environment.
Ensure safe medication use, regulatory compliance, and quality patient care.
Collaborate with healthcare teams through secure digital platforms to resolve medication-related issues.
Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. The organization prioritizes safety and provides an integrated system of healthcare experts committed to exceptional care.
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.
Oversee prior authorization technicians and administrative PA functions.
Analyze data and provide staffing, workflow, and system enhancement recommendations.
Investigate/resolve escalated issues from clients and providers.
Judi Health is an enterprise health technology company providing a suite of solutions for employers and health plans. They have a comprehensive Enterprise Health Platform that consolidates all claim administration-related workflows in one scalable, secure platform.
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.
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.
Leads specialty pharmacy services and medication access for ambulatory clinics across the region.
Supervises daily operations, workflow optimization, and staff development for Specialty Pharmacy Care Coordinators.
Collaborates with management on strategic initiatives, accreditation, and regulatory compliance.
Baptist Health is a full-spectrum health system dedicated to improving community health. Founded in 1924, it employs over 24,000 people and includes 10 hospitals and more than 470 points of 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.
Provide medication management services inclusive of medication access, education, adherence, and comprehensive medication management for pediatric patients.
Act as liaison between the designated region and the medication management center of excellence, ensuring compliance with all regulatory authorities.
Document encounters in the electronic medical record and promote evidence-based, cost-effective medication management.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care, working alongside families, providers, and health plans, with a focus on compassion and an unwavering commitment to children with medical complexity.
Work collaboratively with physicians, nurses, other healthcare providers, and patients to optimize drug therapy and outcomes using evidence-based standards of care.
Responsible for providing effective, efficient and accurate ambulatory pharmaceutical care to achieve organizational, patient care, and quality measure goals and objectives.
Prescribe pharmaceutical agents as outlined in the approved collaborative drug therapy management agreement including initiating, adjusting, and discontinuing drug therapy.
Dignity Health Medical Foundation, established in 1993, provides comprehensive health care services throughout California. They are an affiliate of Dignity Health, one of the largest health systems in the nation, striving to create purposeful work settings where staff can provide great care.
Coordinate medical record retrieval, ensuring complete and timely submission of patient documentation for provider review
Prepare and process referrals to specialists and manage prior authorization requests in coordination with insurance payors
Virtually greet and room patients prior to telehealth appointments, confirming patient information and visit readiness
Synapticure is a patient and caregiver-founded company that provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. They are dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases like Alzheimer’s, Parkinson’s, and ALS.
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.
Take incoming requests for appeals ensuring customer service and maximizing productivity.
Work with appeals team for multiple lines of business ensuring appeal submission for review.
Maintain quality standards, remain current on updated processes, and follow SOPs and HIPAA guidelines.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have full-service health benefit management solutions to employers, TPAs, and health plans.