POSITION SUMMARY Are you ready to step into a position that combines your communication skills, attention to detail, ability to multitask, and unrelenting drive to help others? As a Front End staff pharmacist for Express Scripts Pharmacy you’ll be part of a dedicated team which ensures that our customers receive accurate, appropriate, and timely prescription delivery. You will be on the front lines with doctors’ offices as well as patients, providing drug therapy information and responding to phone inquiries with care and detail. In addition, you will monitor and assure compliance to State and Federal Rules and Regulations, FDA requirements, and complete general product verification checks. How you’ll make a difference: - Be a superstar in the eyes of providers and patients alike: Accept transfer and/or initiate phone calls with physicians’ as well as patients to communicate needed information and answer questions. - Use your expert problem solving skills to help our patients be at their best every day: Collaborate with patients and doctors to research issues with medication therapy and implement the best treatment options to move forward with. - Juggle multiple tasks without sacrificing attention to detail. You will be busy handling multiple requests at any given time. This can include documenting information from your conversations, verifying prescription information is correct, and assuring clinical appropriateness. Essential Functions: - Provide oversight and quality assurance to pharmacy technicians. - Maintain quality and efficiency expectations - Adhere to all state and federal regulations surrounding pharmacy practice - Interpret physicians’ or prescribers’ prescriptions. - Contact doctors and/or patients to verify information on prescriptions such as drug strength, prescription sig., and drug name in order to expedite processing of orders. - Verify and confirm validity of controlled substances. - Review phone calls linked to prescriptions entered by certified pharmacy technicians. - Verify prescription information entered in the system by certified pharmacy technicians. - Consult with patients regarding the use of medications and potential drug interactions. - Assist with clinical questions from prescribers and/or agents of the prescriber. - Read, interpret and follow standard work instructions. - Perform additional duties as assigned by management. What You Should Have: - Graduate of ACPE Accreditation School of Pharmacy with a B.S. Pharmacy or PharmD, degree - Current TN resident pharmacist license in good standing - Highly-evolved clinical pharmacy skills and/or clinical knowledge - Superior written and verbal communication skills - Proficient in use of computer applications - Demonstrated ability to work independently, solve problems and make informed decisions in a timely fashion - Excellent customer service and interpersonal skills - Demonstrated ability to effectively and professionally represent Express Scripts Pharmacy to patients, clinicians, clients and the public Preferred Qualifications: - Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues. - Ability to work effectively in both an in person and virtual setting. - Strong focus on customer service, quality and accuracy. - Ability to manage timelines and meet deadlines. - Ability to adapt in a changing environment. - Ability to work a flexible schedule for peak volume times. - Proficient in use of computer applications including Microsoft Office - Demonstrated ability to work independently, solve problems and make informed decisions in a timely fashion - Established record of performance as a trusted advisor to other healthcare professionals –prescribers in particular If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Position Summary The Health Information Line Nurse is a Registered Nurse responsible for providing telephonic and chat-based clinical triage and health guidance to plan participants. This role supports callers across the full spectrum of care needs from emergent situations to self-care guidance while promoting appropriate healthcare utilization and informed decision-making. The nurse utilizes evidence-based clinical guidelines and online resources to assess symptoms, provide clinical counsel, and direct members to the most appropriate providers or facilities. Additional responsibilities may include proactive patient outreach, benefits education, and health and wellness support. Key Responsibilities - Provide telephonic and chat-based clinical triage for symptom-related inquiries, including emergent, urgent, and self-care outcomes - Assess medical symptoms using established clinical protocols and decision-support tools - Deliver accurate, relevant health and wellness education tailored to member needs - Direct callers to appropriate healthcare providers, facilities, and services - Educate members on available online tools and the Audio Health Resource Library to enhance access to healthcare and wellness information - Maintain clear, concise, and accurate clinical documentation in accordance with standard operating procedures and medical/legal guidelines - Identify and refer members to appropriate programs such as Case Management, Chronic Condition Management, and Health Advisor services - Participate in proactive outreach initiatives to support population health and care management goals Work Schedule & Availability - Operating hours are Monday through Friday, 8:00 a.m. to 9:00 p.m. with shifts scheduled based on operational needs (10 hour shifts) - Mandatory participation in overnight, weekend, and holiday on-call coverage, including rotating on-call schedules, based on operational needs Minimum Qualifications - Active, unrestricted Registered Nurse (RN) license - Minimum of three (3) years of clinical nursing experience - Current knowledge of general medical conditions and surgical procedures - Strong verbal and written communication skills - Proficiency with computer systems and electronic documentation - Ability to meet mandatory on-call scheduling requirements Preferred Qualifications - Bachelor of Science in Nursing (BSN) - More than three (3) years of nursing experience - Strong interpersonal and active listening skills with the ability to work collaboratively in a team environment - Demonstrated adaptability in a dynamic healthcare environment - Proven ability to prioritize, problem-solve, and make independent clinical decisions - Strong customer service orientation with a patient-centered focus If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. *Must be licensed in California Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member. - Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care - Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member - Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered - Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines - Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings - Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members - Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines - Reviews member’s transfer or discharge plans to ensure a timely discharge between levels of care and facilities - Collaborates with care management on referral of members as appropriate - Performs other duties as assigned. - Complies with all policies and standards. Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. 2+ years of acute care experience required. Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: - For Health Net of California: RN license required - **Must be licensed in California Location: Position is remote. Hours: 8:00-5:00 PST. Pay Range: $27.02 - $48.55 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Job Description Schedule: This role supports our weekend operations and requires availability every Saturday and Sunday. The weekly schedule is a 5-day (8-hour) schedule, totaling 40 hours per week. Shifts are scheduled within the hours of 8:00 AM–8:00 PM ET. A bit about this role: As a Clinical Guide, you'll have the opportunity to make a difference in the lives of our members. You'll be responsible for providing clinical review of cases using standard criteria to determine the medical appropriateness of inpatient and outpatient services while supporting our members through assessment, care, and conservation. You'll serve as an advocate for our members, coordinating care and ensuring they have the necessary resources and support to achieve their health goals (recovering from an illness, improving quality of life, overall well-being, etc.) Our Clinical Guide is committed to integrity and excellence and empowering members to confidently navigate the healthcare system and live healthier lives. Our ideal Clinical Guide is caring, compassionate and solutions-oriented, and is enthusiastic about providing outstanding experience for Devoted Health’s members. Your Responsibilities and Impact will include: - Engage with members and understand their needs, using technology and data to better understand the member and any unspoken needs. - Performs initial, concurrent, and discharge reviews of all cases, including using medical guidelines to determine the medical appropriateness of inpatient and outpatient services; assessing, interpreting, and responding to the needs or requirements of patients; identifying, escalating and resolving complex cases or issues as required. - Reviews current charts for appropriateness and correct admission status (inpatient, observation, bedded outpatients). - Alerts and collaborates with appropriate leadership concerning patients who do not meet medical appropriateness criteria. - Obtains admission and continued stay certification or recertification. - Communicates with an attending physician regarding patients who do not meet criteria to identify additional documentation needs or potential status change. - Coordinates care and discharge planning. Makes arrangements for appropriate post-hospital care, including physical and behavioral medicine, transportation, equipment, home health care, etc. - Identifies, documents, and communicates potential quality assurance or risk management issues as appropriate. - Conduct holistic assessment to identify co-morbid conditions, ED/ hospitalization history, medications, psycho-social factors, and member values and preferences. - Collaborate with our PCP partners. - Develop care plans in partnership with members and their caregivers - problems, goals, interventions - continuously evaluating the member’s progress. - Work closely with Local Service Guides to identify community-based organizations to support the members in meeting their goals. - Collaborate with members, providers, and caregivers to ensure a positive outcome. - Explain complicated medical terms in plain language. - Educate members on appropriate care and settings based upon their healthcare needs. - Support members in understanding diagnostic tests and treatments, including costs, risks, and alternatives so they can make an informed decision. - Prepare members for their inpatient and outpatient treatments and coordinate post-treatment care. - Support and coach members to improve management of their chronic conditions, including medication adherence and compliance. Required skills and experience: - Ability to work in a startup, fast paced environment. - An unrestricted RN license. - A minimum of 4 years of RN experience. - A minimum of 3 years’ experience doing utilization management at a health plan. - The ability to comfortably multi- task: you’ll be listening, talking, and typing all at the same time. - Team player mentality with a can-do attitude. - Understanding of CMS guidelines and MA requirements. Desired skills and experience: - A desire to make a change in the health care experience: you love to serve and make a difference. - Proven success in building relationships. - The ability to adjust your tone and approach to different people. - The ability to articulate and break down complex information. - Adaptability and comfort in a dynamic, startup environment. - Transparency in your work - what’s going well and what’s not. #LI-Remote #LI-DS1 Salary Range: $85,000-$100,000 / year The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: - Employer sponsored health, dental and vision plan with low or no premium - Generous paid time off - $100 monthly mobile or internet stipend - Stock options for all employees - Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles - Parental leave program - 401K program - And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission! Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.