Communicate directly with insurance companies to facilitate medication approvals and prior authorizations.
Navigate pharmacy systems to enter data, adjudicate claims, and document patient interactions across multiple databases.
Provide compassionate phone support to patients, helping them manage refills, medication adherence, and pharmacy-related questions.
Shields Health Solutions partners with health systems to provide specialty pharmacy services, helping patients access complex medications. As a growing organization, they emphasize a collaborative culture and patient-centered care, employing pharmacy professionals dedicated to improving medication adherence and health outcomes.
Interpret, evaluate, and summarize information and datasets of varying sizes.
Determine benefit limits and secure insurance approvals for specialty infusion, oral chemotherapy and high-cost medications.
Serve as a resource to patients and staff regarding insurance and drug coverage questions.
Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, it is the only NCI-designated cancer center in Washington, employing a diverse workforce that values collaboration, compassion, and innovation.
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.
Prepare prior authorization requests by validating prescriber and member information and ensuring appropriate clinical guidelines.
Make outbound calls to providers to obtain additional clinical information for pharmacist review.
Review and analyze pharmacy claims data for proactive outreach and intervention.
Judi Health is an enterprise health technology company offering pharmacy benefit management and health benefit solutions for employers and health plans. They are a startup focused on rebuilding trust in healthcare in the U.S.
Verifies patient insurance coverage and submits prior authorizations to insurance plans.
Troubleshoots prior authorization submissions and prescription processing with healthcare providers.
Documents activities and works with Customer Support team to ensure patient success.
PHIL is a health-tech startup pioneering the first Software Therapy Deployment Platform for Specialty Pharmaceuticals. The company employs over 120 individuals and expects to double its employee base in the coming year.
Review and process prior authorizations for biologics, oncology, and specialty therapies with timely and accurate completion.
Manage clinical documentation, submit and track authorization requests, and resolve issues with insurance providers.
Communicate effectively with patients, clinical staff, and insurance representatives to ensure compliance and workflow efficiency.
IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions like Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis. They are a rapidly growing company focused on patient comfort and employee empowerment, with core values of kindness, integrity, and continuous improvement.
Serve as a liaison between patients, providers, and internal teams to coordinate alternative pharmacy sourcing.
Identify and verify sourcing channels for non-covered or high-cost medications.
Track sourcing outcomes, maintain compliance, and support patient access to medications.
CommuniCare Family of Companies is a national leader in post-acute care, providing person-centered services for chronically ill or complex condition patients. With over 19,000 employees across 150+ facilities in six states, it is a family-owned company that values family, heart, and exceptional service.
Serve as a key point of contact between patients, providers, pharmacies, and pharmacy benefit teams to coordinate alternative medication sourcing solutions.
Identify and validate appropriate sourcing options for non-covered, high-cost, specialty, or limited-distribution medications.
Assist with cost comparisons, savings analyses, reports, invoices, and documentation related to pharmacy sourcing activities.
The company helps patients navigate complex pharmacy solutions and alternative medication sourcing pathways. They are a mission-driven organization focused on patient-centered service.
Lead and manage a team of Patient Support Associates to ensure medication adherence and prior authorization support.
Proactively manage support in assigned hospitals and clinics to ensure patients receive medications on time.
Provide front-line supervision, coaching, and performance management to the Patient Support team.
Shields Health Solutions is a fast-growing company specializing in specialty pharmacy management services. They are committed to high quality and patient-centered care, with a focus on employee development and team collaboration.
Support Veterans by answering pharmacy-related telephone inquiries, processing prescription requests, and delivering professional customer service.
Document patient interactions in CPRS, review prescription profiles, and refer clinical questions to pharmacists while maintaining HIPAA compliance.
Collaborate with healthcare teams to resolve medication-related issues and follow established pharmacy support workflows for first-contact resolution.
International SOS Government Medical Services provides healthcare, medical assistance, emergency response, and workforce support to improve patient care and operational readiness worldwide. Founded in 1984, the company operates in over 90 countries and supports government healthcare programs with a focus on veteran services.
Lead and manage a team of Patient Support Associates to ensure medication adherence, prior authorization completion, and financial assistance support.
Partner with hospital and clinic stakeholders through regular meetings and collaboration calls to ensure patients receive medications on time.
Monitor service level metrics, conduct audits, and implement process improvements to optimize workflows and drive performance.
Shields Health Solutions is a fast-growing leader in specialty pharmacy, dedicated to a patient-first culture and mission-driven care. They offer a collaborative, supportive environment with strong career growth and leadership development opportunities.
Review and interpret clinician assessments for prior authorization approvals and care plan recommendations.
Monitor patient adherence across all sites and disease categories, focusing on oncology and specialty states.
Provide medication therapy management including regimen review, drug therapy changes, and patient coaching.
Shields Health Solutions provides integrated support to improve patient care quality. The company employs a team of licensed pharmacists and support staff, focusing on medication adherence and evidence-based care.
Proactively enroll patients in the Shields specialty pharmacy program through outbound calls, explaining the benefits of the service.
Review patient medical records to understand conditions and identify medications that require special handling or supplies.
Work flexible shifts within Eastern Time Zone hours, with occasional Saturday availability, and maintain confidentiality.
Shields Health Solutions provides specialty pharmacy services to health systems, helping patients access medications and support. They are a growing company focused on patient care, employee development, and a collaborative culture.
Manage insurance authorization workflows from initial request through final approval.
Verify insurance eligibility, benefits, and authorization requirements.
Collaborate with clinical and billing teams to ensure timely processing.
The company is a healthcare operations organization focused on managing insurance authorization processes to support patient care. They offer a collaborative remote work environment with cross-functional teams.
Manage prior authorization workflows with vendors, providers, patients, and payors.
Develop processes and training materials for offshore teams to resolve authorization issues.
Own Prior Authorization outcomes and KPIs for your region or payors.
Alpaca Health enables clinicians to become entrepreneurs, starting in autism care. We've raised over $14M in funding and are growing 30% - 50% month over month, serving thousands of patients.
Work with ABA/behavioral health providers to collect patient information and communicate authorization decisions
Verify patient eligibility and benefits with insurers and complete prior authorizations via portals or calls
Manage multiple authorizations and collaborate with product team to automate parts of the process
Silna Health is obsessed with optimizing the broken healthcare system by automating prior authorizations and eligibility checks. Backed by Accel and Bain Capital Ventures, they are a fast-growing company working across behavioral health, physical health, ambulatory care, and post-acute care.
Interprets, evaluates, and dispenses medications remotely via electronic health records, ensuring safe and cost-effective therapy.
Collaborates with multidisciplinary teams to monitor and intervene on drug therapy, optimizing patient outcomes.
Reviews medication orders for completeness and appropriateness, documents interventions, and ensures compliance with clinical guidelines.
Brown University Health is a not-for-profit health system in Providence, RI, comprising three teaching hospitals and multiple community facilities. With over 20,000 employees, the organization is committed to diversity, equity, and inclusion, fostering a respectful and equitable environment.
Act as a patient and family advocate to obtain necessary information and fulfill payer authorization requirements.
Collaborate with providers and staff to ensure successful referral and authorization processes.
Track, follow up, and resolve authorization issues to minimize financial risks.
Lucile Packard Children's Hospital Stanford provides world-renowned pediatric care combining advanced technologies with family-centered care. It is a major children's hospital dedicated to caregiver education and state-of-the-art facilities.
Manage training projects and documentation for pharmacy systems, ensuring compliance and operational support.
Monitor helpdesk and equipment needs, and support strategic initiatives for employee software competence.
Maintain positive relationships with pharmacy, clinical, and hospital staff as an ambassador of VytlOne.
VytlOne provides pharmacy services and technology, enabling pharmacy care with a focus on patient impact. With over 1,500 employees and nearly 100 years of experience, they offer the stability of a Fortune 500 company with startup energy.
Counsel patients via telephonic outreach on medication adherence and make evidence-based recommendations.
Perform focused clinical chart reviews to inform patient interventions and document commitments.
Escalate complex cases to prescribers and meet performance goals such as STARs and HEDIS.
Aledade is a public benefit corporation dedicated to empowering independent primary care practices. Founded in 2014, it has become the largest network of independent primary care in the country, fostering a collaborative, inclusive, remote-first culture.