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.
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.
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.
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.
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.
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.
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.
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.
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.
Collaborate with engineering, product, and data teams to develop and maintain the software platform and improve clinical algorithms.
Serve as a subject matter expert, triage bugs, and respond to clinical questions from providers, users, and leadership.
Conduct user acceptance testing, prepare customer demonstrations, and develop intervention strategies to optimize medication utilization.
Arine is a healthcare technology and clinical services company focused on optimizing medication management through a SaaS platform that combines data science, machine learning, and clinical expertise. Backed by leading healthcare investors, the company manages over 18 million lives and was ranked 236 on the 2024 Inc. 5000 list, fostering a collaborative and mission-driven culture.
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.
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 comprehensive mental health medication management via video intake and follow-up appointments.
Conduct psychiatric evaluations, risk assessments, and patient-centered treatment planning.
Collaborate with Lyra's care team to refer patients to therapy and coaching services.
Lyra Health provides evidence-based mental health care, serving over 20 million people globally through employers and health plans. The company has delivered more than 15 million sessions of care, published over 35 peer-reviewed studies, and emphasizes quality and access.
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.