Conduct high-volume outbound and inbound calls with patients, providers, and pharmacies.
Collaborate with patients to identify and remove barriers to medication adherence.
Accurately document all interactions, outcomes, and identified barriers in appropriate systems.
Aledade empowers independent primary care practices. They were founded in 2014 and have become the largest network of independent primary care in the country, with a collaborative, inclusive, and remote-first culture.
Review patient care notes for clinical data needed for prior authorization approvals.
Monitor patient adherence across all sites and disease categories, focusing on oncology and specialty-specific disease states.
Recommend alternative therapeutic drug regimens and disease-specific treatments according to guidelines.
Shields Health Solutions provides integrated pharmacy solutions to health systems. They focus on improving patient care and outcomes through specialized pharmacy programs and services. The company values innovation, collaboration, and a patient-centered approach.
Review medication orders for accuracy and safety, providing patient counseling.
Collaborate with healthcare providers, monitor drug interactions, and maintain records.
Ensure regulatory compliance, contribute to protocol development, and assist in training.
Shields Health Solutions provides pharmaceutical care services to patients, collaborating with healthcare professionals . They focus on safe and effective medication therapies.
Provide comprehensive medication management, including reconciliation, dose optimization, adherence support, and drug‑level assessments aligned with evidence‑based standards.
Partner with physicians, specialists, and interdisciplinary teams to order individualized care plans under a CPA and promote seamless medication coordination.
Monitor therapy effectiveness and safety, identify optimization and intervene as appropriate.
Shields Health Solutions is redefining patient care through health-system integrated specialty pharmacy. They are known for elevating patient care at nationally recognized Academic Medical Centers and building meaningful relationships with patients and providers.
Coordinate case management activities related to medication optimization, adherence, and therapeutic appropriateness
Collaborate with providers, PBMs, and pharmacy partners to support evidence-based medication use and access
Conduct member outreach, education, and follow-up to support adherence and understanding
Point C is a national third-party administrator (TPA) delivering customized self-funded benefit programs with local market presence. They focus on cost containment strategies with innovative solutions. They are driven by a clear and impactful mission.
Responsible for remote services, including medication interpretation and dispensing.
Collaborates with care providers to ensure safe and cost-effective medication use.
Oversees pharmacy technicians and support staff.
Brown University Health is Rhode Island's largest health system and private employer, offering premier health services and the only Level I Trauma Center for southeastern New England. The not-for-profit system comprises three teaching hospitals of The Warren Alpert Medical School of Brown University and community hospitals offering a broad range of health services.
Partner with payer clients as a trusted clinical advisor to design drug management strategies.
Assess and benchmark PBM and other industry vendor clinical programs.
Leverage medical and pharmacy data to assess program performance.
PSG (Pharmaceutical Strategies Group), an EPIC owned company, provides consultative guidance to payer clients in the drug management market. They have over 3,000 employees nationwide and foster a 50/50 culture between producers and the rest of the business, supporting collaboration and teamwork.
Create innovative clinical programs, products, and services aimed at optimizing specialty and non-specialty drug management, support payer clients with their PBM and drug coverage decisions
Act as a detail-oriented advisor, using data-driven insights to evaluate pharmacy programs, identify trend drivers, outlier high-cost claims and drive improvements.
Monitor emerging market trends and drug pipelines to anticipate client impact and develop proactive solutions.
Pharmaceutical Strategies Group (PSG), an EPIC owned company, provides an integrated data and analytics platform that transforms member data into actionable intelligence, which drives improved management of drug spend and trend across both pharmacy and medical benefits. EPIC has over 60 offices and 3,000 employees nationwide.
Conduct targeted patient outreach to close care gaps and ensure timely care transitions.
Deliver high-touch engagement for high-risk patients to prevent readmissions through follow-up.
Collaborate with Practices to support interventions such as Transitional Care Management.
Aledade empowers independent primary care practices, helping them deliver better care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Conduct routine patient check‑ins to monitor therapy experience, identify concerns, and support adherence to treatment plans.
Assist with initial outreach to confirm therapy start and assess early treatment experience.
Coordinate patient appointments, follow‑up visits, and clinical monitoring schedules.
Shields Health Solutions partners with hospitals and health systems to develop and manage specialty pharmacies. They focus on improving patient outcomes, enhancing financial performance, and ensuring regulatory compliance for their partners.
Investigate pharmacy-related concerns and issues arising before and after EHR Go-Lives, determining root causes and developing effective mitigation strategies
Actively engage with VA Medical Centers to support preparedness, readiness, and operational response during EHR deployment
Work closely with EHRM Solution Experts and stakeholders to resolve identified issues and drive timely, sustainable solutions
Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations, and enhanced service delivery. Founded in 2012, they have 300+ employees nationwide and specialize in applying technology, creativity, and human-centered services to optimize mission delivery.
Develop and maintain a quality audit program for the Clinical Review Team.
Ensure high-quality reviews and adherence to regulatory requirements.
Deliver exceptional member, provider, and employee experiences.
SmithRx is a rapidly growing Health-Tech company that aims to disrupt the Pharmacy Benefit Management (PBM) sector using technology and customer service. The company has a mission-driven and collaborative culture, with hundreds of thousands of members onboarded since 2016.
Develops workflows, protocols, and policies that support efficient and compliant TOC operations.
Provides leadership and supervision to designated groups of employees including assurance of quality service delivered by a competent staff to consistently meet the needs of the hospital patients.
Develop, implement, and continuously improve TOC pharmacy programs aligned with organizational goals and regulatory requirements.
Baptist Health is a full-spectrum health system dedicated to improving the health of the communities it serves. The Baptist Health family consists of 10 hospitals, employed and independent physicians, and more than 470 points of care and employs more than 24,000 people in Kentucky and surrounding states.