Support Pharmacists and patients by conducting medication reviews and optimizing prescription drug therapy.
Make outbound calls and take inbound calls to collect medication history and provide counseling.
Work remotely with a flexible schedule within EST business hours and participate in training with camera on.
Humana is a leading U.S. healthcare company that provides insurance and healthcare services to millions. With a large workforce, Humana fosters a caring community and supports career growth.
Processes electronic medication refill requests and communicates with providers and patients.
Ensures compliance with all HIPAA regulations and maintains patient confidentiality.
Provides excellent customer service and assists with prior authorization and medication assistance guidance.
St. Elizabeth Healthcare provides medical services as one of the largest healthcare providers in the Northern Kentucky region. The organization emphasizes a culture of caring for patients and each other, with a focus on innovation and community.
Assist members, providers, and internal teams in navigating prescription coverage and prior authorization requests.
Verify eligibility, drug coverage, and perform claims adjudication based on plan benefit design.
Triage and prioritize multiple requests, coordinate outreach, and make determinations under protocol.
SmithRx is a health-tech company disrupting the pharmacy benefit management industry with a next-generation drug acquisition platform. With hundreds of thousands of members, they have a mission-driven and collaborative culture guided by values of integrity, courage, and together.
Support pharmacy benefit operations by coordinating clinical and administrative workflows.
Review documentation and communicate with members, providers, and internal stakeholders.
Ensure accurate and compliant processing of pharmacy benefit requests.
We are an innovative company striving to reduce the cost of healthcare. We have a tight-knit culture based on an outward mindset and are growing quickly.
Manage prescription workflows and provide clinical and operational support to the pharmacy enablement team.
Collaborate with RNs, providers, and coaches to coordinate care and resolve member issues.
Process clinical tickets, route faxes and records, and follow SOPs to maintain compliance.
Virta Health works to reverse metabolic disease in one billion people using technology, personalized nutrition, and virtual care delivery. It is a remote-first company backed by over $350 million from top-tier investors, partnering with health plans, employers, and government organizations.
Triage clinical program calls, schedule consultations, and conduct outreach to members, prescribers, and pharmacies.
Monitor outreach queues, document case activities, and escalate issues to ensure timely completion of clinical programs.
Maintain compliance with HIPAA and internal SOPs while providing compassionate, professional support to members and providers.
Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. They consolidate pharmacy and medical benefits on a unified platform, leveraging AI-powered care delivery to enhance efficiency and service. The company is a growing startup focused on transforming healthcare infrastructure.
Conduct thorough research on attributed patients to understand their healthcare needs and barriers to enrollment.
Perform telephonic outreach to caregivers and healthcare professionals to enroll children and ensure a seamless onboarding experience.
Develop deep knowledge of SSI program and collaborate with Provider Engagement Specialists to support enrollment efforts.
Imagine Pediatrics is a tech-enabled pediatrician-led medical group reimagining care for children with special health care needs. It is a startup with a values-driven culture focused on compassion and innovation.
Review, process, and troubleshoot incoming Prior Authorization requests for various medications.
Accurately process requests according to regulatory and client-specific guidelines while meeting departmental performance metrics.
Work with clinical teams and handle requests via phone, fax, and web submission.
Navitus is a pharmacy benefit manager (PBM) alternative focused on reducing drug costs to make medications more affordable. The company offers a diverse and creative work environment with numerous employee benefits and growth opportunities.
Triage incoming clinical programs calls, schedule consultations, and conduct outreach to prescribers, pharmacies, and members.
Manage and maintain drug lists to support clinical programs, including periodic maintenance and ad-hoc updates.
Support reporting requirements, monitor claims, and ensure communication among internal and external stakeholders.
Judi Health is a health technology company providing benefit administration solutions with Unified Claims Processing architecture. It operates in a startup environment, deploying infrastructure for millions of Americans.
Provide exceptional phone-based customer service and process prescriptions with speed and accuracy.
Perform claim adjudication, billing, and eligibility checks while maintaining detailed patient records.
Act as a liaison between pharmacists and medical professionals, placing outbound calls to support patient care.
AnewHealth is a leading pharmacy care management company specializing in complex, chronic patient care. With over 1,400 team members and an award-winning culture, we serve more than 100,000 people across all 50 states.
Conduct high-volume outbound and inbound calls with patients, providers, and pharmacies to support medication adherence.
Collaborate with patients to identify and remove barriers to medication adherence, escalating clinical issues to pharmacists.
Document interactions and coordinate with providers and pharmacies to ensure prescription refills occur as scheduled.
Aledade PBC is a public benefit corporation that empowers independent primary care practices to thrive in value-based care. Founded in 2014, it has become the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Perform patient-specific medication reviews and develop recommendations for medical drug utilization management and Medication Therapy Management.
Resolve medication and pharmacy issues for members triaged from Member Services or other departments.
Act as subject matter expert for audits, quality improvement, and LEAN projects.
IEHP is a not-for-profit health plan dedicated to healing and inspiring the human spirit by providing quality healthcare services to members. They emphasize a supportive culture with career growth and wellness programs for their team.
Provide comprehensive virtual acute care for medically complex pediatric patients via telehealth.
Execute clinical triage protocols to determine patient disposition for acute illnesses.
Collaborate with interdisciplinary teams to plan and implement patient-centered care.
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, enhancing existing care teams with an extra layer of support.
Provides comprehensive medication management and patient counseling through telephone consultations.
Completes medication reviews to ensure safety, efficacy, and cost-effectiveness.
Collaborates with healthcare professionals to optimize therapeutic outcomes.
Dartmouth Health is a nonprofit academic health system delivering advanced medical care and research. It is one of New England's largest employers with a culture that values innovation and teamwork.
Support medication-focused clinical programs to improve patient health outcomes and medication adherence through education, outreach, and medication reviews.
Conduct outbound calls to confirm medication use, provide education, and counsel patients on complex regimens.
Use electronic health record systems to document interactions accurately and support efficient clinical workflows.
This company provides medication-focused clinical programs to improve patient health outcomes and medication adherence. It operates as a fully remote team with multidisciplinary collaboration, though specific size and culture are not detailed.
Triage clinical incoming calls and conduct outreach to members, pharmacies, and prescribers.
Support operations of clinical programs including pharmacogenomics, MTM, and lower cost alternatives.
Ensure customer satisfaction and meet performance metrics while maintaining quality and compliance.
Judi Health is a health technology company providing benefit administration solutions to employers, unions, and health plans, using a unified claims processing platform. The company focuses on transparency and efficiency, serving millions of Americans.
Supervises representatives, manages performance, and provides feedback through side-by-side and recorded call reviews.
Handles escalated calls, partners with business units, and coordinates team schedules to maximize efficiency.
Monitors volumes for pending queues and ensures timely processing of prior authorization forms.
PharMerica is a long-term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States. It operates as part of BrightSpring Health Services, combining personalized care with the resources of a national network.