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.
Grow the number of new patients filling at Shields partner pharmacies.
Lead, coach, and inspire a team of outreach coordinators.
Develop new patient engagement strategies and optimize outreach workflows.
Shields Health Solutions partners with health systems to build specialty pharmacy programs. They are a growing organization focused on operational excellence and a winning culture.
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.
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.
Act as the primary point of contact for incoming member calls, prior authorization inquiries, and ensure appropriate escalation of cases.
Efficiently triage incoming calls with professional phone etiquette from members, prescribers, and pharmacies with minimal support.
Meet all departmental goals including schedule adherence, attendance, and quality monitoring.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They are building trust in healthcare in the U.S. and deploying infrastructure for better care.
Conduct research and quality assurance for drug and biological policies.
Write business logic and translate industry references into Cotiviti policy.
Mentor new team members and assist with customer inquiries regarding clinical rules.
Cotiviti is a healthcare analytics company that provides clinical coding and policy solutions for health plans. They focus on maintaining accurate medical policy libraries and employ a global team, offering benefits like PTO and paid family leave.
Reviews, verifies, and interprets all physician orders received using the patient profile.
Screens medication orders for optimal usage, monitoring for allergies, interactions, and appropriate dosing.
Participates in continued education to meet regulatory requirements and organizational goals.
CommonSpirit Health is one of the nation's largest nonprofit Catholic healthcare organizations, delivering over 20 million patient encounters annually. With more than 157,000 employees, 45,000 nurses, and 25,000 physicians across 24 states, the organization focuses on creating a more just, equitable, and innovative healthcare delivery system.
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.
Lead and manage a team of Patient Engagement members to ensure timely medication refill support and high-quality patient care.
Proactively manage support in assigned hospitals and clinics to ensure patients receive medications on time and service level goals are met.
Provide ongoing coaching, performance management, and professional development to drive team success and adoption of best practices.
Shields Health Solutions provides patient engagement and pharmacy support services to hospitals and clinics. It is a fast-growing company with a focus on high quality and accountability.
Handle inbound pharmacy calls and make outbound refill reminders to guide patients through the refill process.
Coordinate medication refills including data entry, claim adjudication, and resolving patient and provider inquiries.
Collaborate with pharmacists, clinicians, and internal teams to ensure timely and accurate patient support and process improvements.
Shields Health Solutions is a healthcare company that focuses on patient engagement and medication refill support for pharmacies. The company is large enough to offer benefits like medical, dental, and vision insurance, 401(k) match, and paid parental leave, and emphasizes a collaborative and supportive culture.
Assists with patient medication management and facilitates medication renewal requests.
Acts as a liaison between providers, patients, and pharmacies for prescriptions and prior authorizations.
Monitors prior authorization status and updates relevant parties throughout the process.
Mass General Brigham is a not-for-profit integrated health care system supporting patient care, research, teaching, and community service. They employ a diverse team of professionals including doctors, nurses, and tech experts, fostering a collaborative culture focused on exceptional care.
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.
Shields Health Solutions is a healthcare company that partners with health systems to deliver specialty pharmacy services. They focus on patient engagement and medication adherence through integrated care models.
Lead operational execution for pharmacy services, ensuring efficiency, profitability, and patient care excellence.
Mentor staff, manage client relationships, and oversee compliance with laws and accreditation standards.
Handle staffing, scheduling, inventory control, and training to optimize pharmacy workflows.
VytlOne is a pharmacy services and technology company that enables pharmacy care, with a focus on health system pharmacies. With nearly 100 years of experience and 1,000 employees, it combines Fortune 500 stability with startup energy and promotes a culture of teamwork and flexibility.
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.
Provide local oversight of the 340B program and ensure compliance with federal regulations.
Manage split-billing software maintenance and conduct self-audits to maintain audit readiness.
Serve as the primary liaison for all 340B-related matters and coordinate external audits.
Baptist Health is a full-spectrum health system dedicated to improving the health of the communities it serves. It employs more than 24,000 people across Kentucky and surrounding states, with 10 hospitals and numerous points of care.
Provide operational support to pharmacy and clinic partners, ensuring timely resolution of order issues and maintaining safety stock levels.
Investigate and resolve order-related delays, allocation discrepancies, and stock concerns while collaborating with cross-functional teams.
Generate regular reports on KPIs, conduct audits, and develop process documentation to enhance operational efficiency.
Montu is Australia's largest healthtech business focused on alternative healthcare, supporting patients, doctors and pharmacies through its Alternaleaf clinic, SAGED platform, and Leafio dispensing solutions. Founded in 2019, it has been recognized as Australia’s fastest-growing tech company (#1 in Deloitte TechFast 50 in 2022 and 2023) and #1 on LinkedIn's Top Startups Australia 2024, cementing its position as the largest business of its kind outside North America.
Receive and respond to prescription refill requests via phone, email, fax, and Telephone Encounter.
Verify validity and accuracy of refill requests, ensuring compliance with regulatory guidelines.
Provide exceptional customer service and collaborate with interdisciplinary teams to optimize workflow.
Carenet Health pioneers advancements in healthcare consumer experience, interacting with 1 in 3 Americans daily to improve outcomes. They foster a collaborative, innovative culture with an entrepreneurial spirit.
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.
Manage provider and clinic compliance relationships, including onboarding and edge case resolution for approximately 3,500 clinics.
Lead investigations into prescribing pattern anomalies and credential lapses, producing written summaries and communicating outcomes.
Build and deliver compliance training for the sales team and develop provider-facing educational materials.
Strive Pharmacy is a personalized compounding pharmacy focused on individualized care and genuine partnership with patients and providers. The company is growing and seeks people who share their conviction for a more human approach to healthcare.
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.