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.
Conduct high-volume calls with patients, providers, and pharmacies using established protocols.
Collaborate with patients to remove barriers to medication adherence and escalate clinical barriers to a pharmacist.
Accurately document all interactions, outcomes, and identified barriers in appropriate systems.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. Founded in 2014, they've become the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
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.
Analyzes and answers inquiries regarding pharmacy claims adjudication.
Adjudicates pharmacy claims and processes pharmacy claims for payment.
Performs varied activities and moderately complex administrative/operational/customer support assignments.
Humana is committed to helping people live healthy lives, creating personalized experiences, and working collaboratively. They offer medical, dental, and vision benefits, a 401(k) retirement savings plan, and paid time off.
Answer new referral intake and refill calls in a timely and professional manner, accurately updating information in the computer system.
Contact patients to collect necessary information for their medical chart, schedule deliveries for refills, and set up shipping arrangements as needed.
Work cooperatively with all departments to maintain accurate patient records, exemplify excellent customer service, and participate in training programs and meetings.
VytlOne is transforming the pharmacy industry to create healthier lives through services across Pharmacy Benefit Management, Pharmacy Management, Specialty Pharmacy, 340B, Rebate and Formulary Management, and Pharmacies. The company fosters a diverse, progressive, and team-oriented culture that promotes a work-from-home model and innovation.
Support daily pharmacy operational workflows and administrative tasks to ensure timely and accurate prescription processing.
Provide frontline operational support to clinicians and internal teams for routine pharmacy workflow questions and requests.
Collaborate with the CX team to assist with basic prescription-related member issues and inquiries.
Lifeforce is the world's largest longevity medicine program. They bring together diagnostics, clinical experts, health coaches, and customized protocols to help people understand and optimize their bodies, functioning now and decades to come. They seem to have a modern and proactive company culture.
Responsible for supporting the implementation, maintenance, analysis, and quality assurance of ConnectiveRx pharmaceutical affordability programs.
Accountable for program set-ups and maintenance, performs quality control on program setups and updates, and investigates adjudication outcomes and data discrepancies.
Applies business rules consistently to ensure operational accuracy and program integrity and works independently on routine tasks.
ConnectiveRx helps pharmaceutical manufacturers untangle the complex prescription process. They bring together diverse voices to allow patients to build trusting relationships with their medication brands. ConnectiveRx offers comprehensive benefits including medical, dental, vision, life, and disability insurance.
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.
Provide remote pharmacy services, including order entry, verification, and clinical review to ensure safe and accurate medication use.
Collaborate with physicians, nurses, and interdisciplinary care teams to deliver timely clinical recommendations and improve patient outcomes.
Evaluate medication orders, identify potential interactions or risks, and recommend appropriate therapeutic adjustments.
The Cigna Group is dedicated to improving the health and vitality of those it serves. Through its divisions Cigna Healthcare and Evernorth Health Services, they enhance the lives of clients, customers and patients.
Provide comprehensive medication management and drug‑level assessments.
Partner with physicians and interdisciplinary teams to order individualized care plans.
Monitor therapy effectiveness and safety, and provide recommendations to operations.
Shields Health Solutions is redefining patient care through health-system integrated specialty pharmacy. They are dedicated to elevating patient care at a nationally recognized Academic Medical Center and building meaningful relationships with patients and providers.
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.
Act as a designated support resource for assigned Account Managers.
Responsible for troubleshooting escalated items related to claims, eligibility, and general account maintenance.
Collaborate with cross-functional internal teams for client issue resolution.
SmithRx is a rapidly growing, venture-backed Health-Tech company that aims to disrupt the Pharmacy Benefit Management (PBM) sector. They have hundreds of thousands of members onboarded since 2016 and pride themselves on a mission-driven and collaborative culture.
Identify customer needs and cultivate effective sales strategies via phone and email, establishing a consistent pipeline through daily lead generation.
Design and execute strategic business plans with detailed action items to drive profitable revenue growth, while managing complex transactions and resolving operational issues.
Engage in business and sales opportunities to achieve objectives, leveraging detailed product knowledge to identify add-on and cross-selling opportunities for customers and prospects.
PointClickCare provides software solutions for the healthcare industry. It operates in a fast-paced, team-oriented environment where collaboration is key to success.
Identify customer needs and cultivate sales strategies via phone and email to drive profitable revenue growth.
Generate a consistent daily pipeline through lead generation, prospecting, and cold calling to engage small-medium service-based companies.
Manage and resolve complex transactional operations, leveraging detailed product knowledge to identify add-on and cross-selling opportunities.
PointClickCare develops software solutions for the healthcare industry. The company operates in a team-oriented environment focused on driving growth and value in the senior care market.
Primarily responsible for making outbound calls to healthcare providers.
Accepting inbound calls from healthcare providers.
Answer questions about participation requirements, registration, assessment completion and scoring results.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With over 66,000 employees, we combine scale, expertise and execution to create meaningful, measurable impact.
Provide proactive account management including helping entities manage a compliant 340B program, owning and building relationships with managed accounts.
Develop a communication plan with the client that promotes awareness about products, tools, interfaces, modules, and services.
Ensure customer expectations are met by maintaining open, clear, and consistent dialogue with external end-users and internal contacts.
VytlOne provides services and technology that fuel the entire pharmacy ecosystem, enabling pharmacy care. They're a company of 1,000 diverse people with almost 100 years of pharmacy experience, offering the stability of a Fortune 500 company with the energy and innovation of a startup.
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.
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.
Handle inbound patient requests via phone, text, and email by reviewing order details to provide accurate information.
Partner with internal and external operational teams to ensure prescriptions are processed and delivered successfully.
Assist patients in navigating their portal and explaining insurance coverage to help them receive medication promptly.
Helpware is a technology-driven company that provides Customer Experience & Operational Support for modern companies. It has offices in the USA, Ukraine, Mexico, and the Philippines and focuses on leveraging empowered teams, innovative solutions, and technologies to deliver best-in-class services to partners.