Manage provider schedules and prepare charts for upcoming home visits.
Conduct outreach for scheduling, appointment confirmation, and wellness checks for high-risk members.
Obtain medical records, submit referral authorizations, and coordinate lab orders and transportation for members.
Alignment Health is dedicated to reshaping senior care, empowering members to age gracefully and live vibrantly. Their mission-driven team strives to deliver high-quality, affordable care to members daily.
Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
Assess payment determinations using clinical information and established guidelines.
Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), they empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth.
Collaborates with members, family, and healthcare providers to coordinate services and address barriers.
Guides members to achieve optimal health by providing tools and information to understand their healthcare options.
Identifies and assesses members’ medical, behavioral, social, emotional, and financial needs.
Capital Blue Cross promises to go the extra mile for their team and community. They are one of the “Best Places to Work in PA”, with a caring and supportive culture that values professional and personal growth through training and continuing education.
Communicate with insurance companies to facilitate medication approvals.
Navigate pharmacy systems to input data and prepare action plans.
Communicate with patients and clinician offices regarding medication access.
Shields Health Solutions focuses on improving patient care by removing barriers to medication access. They value creating a positive and inclusive work environment where employees can grow their careers.
Provide non-promotional disease state education and therapy support to identified customers as directed by the client company.
Collect, confirm, and enter demographic data into the client's CRM system for program enrollment and documentation.
Maintain excellent quality and customer service while adhering to program guidelines and using only approved materials.
Inizio Engage is a strategic, commercial, and creative engagement partner that specializes in healthcare. They have over 7,000 experts working in more than 20 countries, forming a passionate, diverse team with global reach and local knowledge.
Answer inbound calls and return voicemails from members, delivering exemplary customer service and support.
Troubleshoot and resolve prescription-related issues for members whose plans utilize CVS or Carelon as the PBM.
Coordinate with providers’ offices and retail/mail-order pharmacies as needed to resolve claims processing, prior authorization, and medication access issues.
Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. They focus on cost containment strategies and driving down the cost of plans with innovative solutions. Point C provides equal opportunity in all employment practices.
Make outbound calls to eligible cancer survivors to introduce OncoveryCare and support them in scheduling care
Ensure patients have the information and tech support needed to access their first appointment
Work closely with the care team to troubleshoot issues and ensure a smooth experience for every patient
OncoveryCare is a virtual healthcare company rethinking physical and mental healthcare for cancer survivors. Their team includes cancer survivors, clinicians, and healthcare delivery experts who provide whole-person support for survivors throughout their cancer journey.
Maintain full ownership and accountability for initiating phone contact to potential study participants.
Conduct phone-based pre-screening interviews for potential study participants to determine pre-qualification status.
Consistently provide outstanding customer service with every patient interaction.
M3 Wake Research is an integrated network of premier investigational sites meeting clinical research needs. They have close to 30 owned and managed research sites across the country and continue to grow through acquisitions.
Responds to inquiries with professionalism and empathy, providing cancer-related information.
Meets constituent needs by providing information on ACS programs and cancer-related resources.
Meets established performance goals and metrics while staying current on policies and procedures.
The American Cancer Society is dedicated to ending cancer, supporting patients, families, and caregivers by providing crucial cancer-related information. A diverse culture comprised of backgrounds and experience, to better serve our communities can be found here.
Build trusting relationships with patients, families, and providers, addressing health questions and care needs.
Identify medical, behavioral, social, emotional, and financial needs to support whole‑person care.
Strengthen the connection between patients and healthcare providers by addressing barriers and facilitating communication.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence, with the goal to make great healthcare affordable, improve patient health, and restore fulfillment for providers. They leverage remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.