This page tracks remote pharmacist openings that are location-eligible for Massachusetts.
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Gentiva is a combined palliative, family hospice, and personal care provider. Formerly part of Kindred at Home’s personal care, family hospice, and palliative divisions, the team
Role Description We are looking for a Remote Clinical Care Coordinator to join our team. This work-from-home telephonic nurse role reports directly to the Director, Contact Center. The Clinical Care Coordinator is responsible for providing expert support in post-acute care navigation and serving as a knowledgeable resource on our services, including home health, hospice, and palliative care. The Clinical Care Coordinator ensures continuity of care for patients transitioning into or out of our services, determines appropriate levels of care, and educates patients and families on available post-acute care options. This position plays a critical role in connecting patients with the right services while ensuring a seamless, compassionate experience. The schedule is: - Saturday & Sunday 8pm to 8:30am - Friday 12am to 8:30am - Thursday 11am-7pm Key Responsibilities - Serve as the main point of contact for patients and families transitioning from or seeking post-acute services. - Make clinical level-of-care determinations using discussions, medical records, and other clinical data. - Provide patient education and guidance on home health, hospice, palliative care, Medicare coverage, billing, and other healthcare resources. - Act as a customer advocate throughout the referral process to ensure timely responses and maximize admissions conversion rates. - Coordinate follow-up and track referral outcomes to ensure high-quality care transitions. - Utilize multiple tools and methods to provide patient options and recommendations regarding post-acute care. - Assist in the admissions process, supporting patients who meet requirements and ensuring satisfaction with services. - Maintain awareness of departmental performance objectives and patient satisfaction goals. Qualifications - Associate degree required; Bachelor’s degree preferred. - Minimum of 3 years of post-acute care experience. - Home health and hospice experience strongly preferred. - Licensed Registered Nurse (preferred) or LPN with active professional licensure in a compact state (must be willing to obtain additional state licensure as required). - Strong knowledge of home health, hospice, and palliative care services. - Excellent communication, analytical, and customer service skills. - Strong computer and technology skills; proficiency in Microsoft Office Suite. Benefits - Competitive Pay - 401(k) with Company Match - Career Advancement Opportunities - National & Local Recognition Programs - Teammate Assistance Fund - Medical, Dental, Vision Insurance (Full-Time) - Mileage Reimbursement or Fleet Vehicle Program (Full-Time) - Generous Paid Time Off + 7 Paid Holidays (Full-Time) - Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care) (Full-Time) - Education Support & Tuition Assistance (ASN to BSN, BSN to MSN) (Full-Time) - Free Continuing Education Units (CEUs) (Full-Time) - Company-paid Life & Long-Term Disability Insurance (Full-Time) - Voluntary Benefits (Pet, Critical Illness, Accident, LTC) (Full-Time) Legalese - This is a safety-sensitive position. - Employee must meet minimum requirements to be eligible for benefits. - Where applicable, employee must meet state specific requirements. - We are proud to be an EEO employer. - We maintain a drug-free workplace.
• Leads the strategic development of formulary management best practices & medical drug strategies • Ensures efficient operational management with emphasis on execution and performance enhancement • Oversees monitoring of drug development pipeline and educates stakeholders • Ensures timely and accurate implementation of benefit and formulary changes • Participates in the negotiation of direct rebates with pharmaceutical manufacturers • Develops methods to identify and measure cost savings opportunities • Collaborates with stakeholders to create drug and utilization management strategies
ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management, and related services. Clients include property and casualty insurance carriers, law firms, third-party claim administrators, and government agencies. Services confirm the veracity of claims by sick or injured individuals under automotive, disability, liability, and workers' compensation insurance coverages.
Role Description AllMed is looking for a dedicated Pharmacy Technician to join our growing team! This is your chance to work in a dynamic, supportive environment where your skills and attention to detail help improve lives every day. The Pharmacy Technician is responsible to ensure reports are of the highest quality and integrity and in full compliance with client contractual agreement, regulatory agency standards and/or federal and state mandates. This position is 100% remote and full time. Responsibilities may include: - Performs quality assurance review of reports, correspondences, addendums or supplemental reviews. - Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations. - Ensures that all client instructions and specifications have been followed and that all questions have been addressed. - Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications. - Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards. - Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report. - Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists. - Ensures the provider credentials and signature are adhered to the final report. - Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed. - Assists in resolution of customer complaints and quality assurance issues as needed. - Ensures all federal ERISA and/or state mandates are adhered to at all times. - Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications. - Promotes effective and efficient utilization of company resources. - Participates in various educational and or training activities as required. - Performs other duties as assigned. Qualifications - A minimum of two years of working as a pharmacy tech or clinical/related field experience equivalent combination of education and experience. - High school diploma or equivalent required. - Active Pharmacy Tech License/ Certificate. - Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values. - Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages. - Must be a qualified typist with a minimum of 40 W.P.M. - Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet. - Must possess excellent skills in English usage, grammar, punctuation and style. - Ability to accurately follow instructions and respond to directions from upper management. - Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met. - Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed. - Must be able to work independently, prioritize work activities and use time efficiently. - Must be able to maintain confidentiality. - Must be able to demonstrate and promote a positive team-oriented environment. Benefits - Fast-paced team atmosphere. - Competitive benefits (medical, vision, dental). - Paid time off. - 401k. Company Description AllMed provides clinical decision making and utilization management solutions to leading payer and provider organizations. We work closely with your team toward a shared vision of healthcare that delivers the highest quality, values patient experience, and ensures both appropriate care and utilization of health-related services.
AllMed provides clinical decision making and utilization management solutions to leading payer and provider organizations. We work closely with your team toward a shared vision of healthcare that delivers the highest quality, values patient experience, and ensures both appropriate care and utilization of health-related services.
Role Description AllMed is looking for a dedicated Pharmacy Technician to join our growing team! This is your chance to work in a dynamic, supportive environment where your skills and attention to detail help improve lives every day. The Pharmacy Technician is responsible to ensure reports are of the highest quality and integrity and in full compliance with client contractual agreement, regulatory agency standards and/or federal and state mandates. This position is 100% remote and full time. Responsibilities may include: - Performs quality assurance review of reports, correspondences, addendums or supplemental reviews. - Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations. - Ensures that all client instructions and specifications have been followed and that all questions have been addressed. - Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications. - Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards. - Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report. - Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists. - Ensures the provider credentials and signature are adhered to the final report. - Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed. - Assists in resolution of customer complaints and quality assurance issues as needed. - Ensures all federal ERISA and/or state mandates are adhered to at all times. - Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications. - Promotes effective and efficient utilization of company resources. - Participates in various educational and or training activities as required. - Performs other duties as assigned. If you're ready to take the next step in your pharmacy career, we’d love to hear from you! Qualifications - A minimum of two years of working as a pharmacy tech or clinical/related field experience equivalent combination of education and experience. - High school diploma or equivalent required. - Active Pharmacy Tech License/ Certificate. - Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values. - Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages. - Must be a qualified typist with a minimum of 40 W.P.M. - Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet. - Must possess excellent skills in English usage, grammar, punctuation and style. - Ability to accurately follow instructions and respond to directions from upper management. - Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met. - Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed. - Must be able to work independently, prioritize work activities and use time efficiently. - Must be able to maintain confidentiality. - Must be able to demonstrate and promote a positive team-oriented environment. Benefits - Fast-paced team atmosphere. - Competitive benefits (medical, vision, dental). - Paid time off. - 401k. Company Description AllMed provides clinical decision making and utilization management solutions to leading payer and provider organizations. We work closely with your team toward a shared vision of healthcare that delivers the highest quality, values patient experience, and ensures both appropriate care and utilization of health-related services.
Through our exceptional health care services, we reveal the healing presence of God.
Role Description Under the direct supervision of a pharmacist and in accordance with standard procedures, provides coordination and leadership for workflows and process improvement within a specialized operational area that spans multiple ministries. At least 80% of time is dedicated to this focused role, which may include areas such as community operations, technology and automation, regulatory compliance, finance, medication access and adherence, transitions of care, and purchasing. - Performs daily services and functions of the specialized role at multiple ministries or in a centralized service model. - Interacts in a matrix manner that includes learning multiple workflows for various sites, travel, managing matrix relationships and collaborating across team members and ministries to prioritize and efficiently complete work. - Solves issues in the specialized area as they arise. - Ensures documents and records are accurate and completed in a timely manner. - Serves as a resource in the specialized area for other regional, system, and/or external stakeholders. - Solves complex problems that may impact more than one ministry and ensures that issues are escalated and closed as needed. - Complies with legal, regulatory, and accreditation standards. - Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices. - Coaches team members across multiple ministries when practice standards are not upheld. - Conducts reviews and audits of specialized area. - Reports and monitors KPIs to ensure optimal performance. - Identifies quality improvement opportunities based on specialized skill set to ensure safe, effective, and efficient services and patient care. - Creates system standardization and leads implementation of operational changes and advancements. - Participates in regional or system specialized work teams, committees, and councils. - Collaborates with regional or system leaders to develop and coordinate team member education, training, orientation, and competency. - Trains other team members in specialized area. - Prepares and distributes work schedules and provides cross-coverage for specialty area, as assigned. - Serves as the multi-ministry or regional liaison to regional or system pharmacy teams in specialty area. - Collaborates with leadership to communicate changes in specialty area. - Provides excellent customer service to patients, other staff and ancillary departments and maintains high standards of confidentiality in accordance with the Health Insurance Portability and Accountability Act (HIPAA). - Works in a constant state of alertness and safe manner. - Performs other duties as assigned. Qualifications - High School diploma/GED or 10 years of work experience. - Three years’ experience as a pharmacy technician or relevant healthcare field. Requirements - Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. - Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. - Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. - Frequent use of hearing and speech to share information through oral communication. - Frequent keyboard use/data entry. - Occasional bending, stooping, kneeling, squatting, twisting and gripping. - Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. - Rare climbing. Benefits - Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). - Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. - Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.
Reimagining pediatric health care. Together.
• Manage, triage, and assign clinical pharmacy referrals to appropriate clinical pharmacy team member • Support internal and external team members in the clinical pharmacy referral process based on patient needs • Schedule patient/caregiver appointments for pharmacist-driven clinical programs • Prepare charts in advance of Clinical Pharmacist appointments • Communicates with pharmacies, insurance companies, and internal team members to resolve medication access barriers with the support of pharmacist where needed • Completes medication histories • Monitor incoming medication renewal requests and manage per internal protocols, where allowable by state law, and seek assistance when outside renewal protocols • Monitor incoming prior authorization requests and prepare documentation for review by clinical pharmacist • Demonstrates the ability to set priorities, work independently (with pharmacist oversight and review of final product) and cooperatively with others within and outside the department. • Perform other duties as assigned
Arine optimizes medication to ensure each patient is on the safest, most effective therapy for their unique health needs
• We are looking for a Lead Clinical Pharmacist to assist in leading one of the clinical teams that uses the Arine platform to deliver excellent outcomes for our customers. • The Lead Clinical Pharmacist is part of a team of clinicians, analysts, clinical support staff, and trainees utilizing Arine’s software platform to help optimize patient outcomes for our clients. • The purpose of the Lead Clinical Pharmacist position is to assist in managing a patient engagement program that achieves four and five-star results across a variety of Medicare Part C and Part D measures. • The position leads and oversees expert level medication therapy consultation to patients and providers, collaborates with the Engineering team and leadership to improve Arine’s software platform, and supervises a team of Pharmacists who are directly reviewing medication profiles and counseling patients, interacting with other health professionals to help improve patient outcomes. • The Lead Clinical Pharmacist partners with the Clinical Support Lead to achieve results by setting a strategic approach with Arine leadership and with other Clinical Care Leads to drive excellent medication outcomes and by engaging client teams and Arine Customer Success to align expectations and communicate roadblocks and progress.
Arine optimizes medication to ensure each patient is on the safest, most effective therapy for their unique health needs
• Engage patients over the phone to deliver Arine's clinical services, including conducting Medication Therapy Management (MTM) services such as Comprehensive Medication Reviews (CMRs) and Targeted Medication Reviews (TMRs), medication adherence counseling, medication reconciliation, and clinical program education on behalf of their health plan • Review completed medication reviews and counseling by other Virtual Pharmacist users, as assigned • Evaluate, assess, and document patient data in Arine's software platform and other programs; prepare written reports and providing oral reports concerning patient care and team progress • Follow up with clinics, providers, pharmacies, and patients to resolve patient issues and concerns in a timely manner, including transitions of care • Develop intervention strategies to optimize medication utilization, achieve quality measures, and meet other established goals • Manage a consistent volume of patient, provider, and pharmacy interactions while maintaining productivity and service quality • Meet individual and team performance metrics related to outreach, engagement, documentation quality, and clinical outcomes • Adapt and rotate across clinical projects and assignments based on evolving business and client needs • Identify opportunities to improve workflows and Arine's software platform by participating in meetings, collaborating cross-functionally, submitting tickets, and leveraging automation and technology to drive efficiency • Provide daily sign-out and maintaining clear handoff communication to ensure continuity of care • Coach and supporting Clinical Care team members and orienting new Virtual Pharmacist users to workflows and the platform
ArchWell Health aims to transform healthcare for seniors and focuses on quality care, empathy, and community outreach. The company fosters a collaborative cultu
Role Description The Pharmacy Technician is an important colleague of ArchWell Health Pharmacy Team. Reporting to the Clinical Pharmacist, the Pharmacy Technician will be providing direct patient care and collaborating with other healthcare team members in a virtual environment to optimize the pharmaceutical care for our patients. This individual will conduct patient outreaches per existing protocols and assist patients with navigating the medication use aspects, including reviewing components of their plan benefits. An ideal candidate will have a deep understanding of Medicare Advantage prescription benefits, possess strong attention to detail, and be driven by a passion for providing quality care to seniors. Duties/Responsibilities - Conduct telephonic outreaches and answer incoming calls regarding member’s medication use, including but not limited to medication adherence, refill request, and medication clarification. - Obtain member’s permission and place refill requests with pharmacies via phone or web systems. - Access medication adherence gap portals or lists and review member’s medical chart notes to determine appropriate action. - Review and process pharmacy refill requests, either via faxes, EMR routes, or direct incoming calls, per established protocol while meeting the expected turnaround time. - Collaborate with other pharmacy staff, providers, and their care teams as needed to resolve any issues or discrepancies related to medication use. - Ensure that all tasks are completed timely, documented accurately, and in accordance with regulations (including HIPAA) and organizational standards. - Attend staff meetings and provide input into current trends, process evaluation, and quality improvement. - Assist with other pharmacy departmental initiatives as they become available. - Additional duties, as assigned. Qualifications - Excellent customer service and communication skills, including telephone etiquette skills, active listening skills, and the ability to follow-through with patients or staff members. - Ability to work effectively and respectfully with colleagues and diverse populations including members, staff, providers, and family members. - High degree of emotional intelligence and integrity, resilient and focused work ethic, with adaptability to handle frequent changes with a positive attitude. - Self-starter with the ability to think creatively and work effectively. - Strong attention to detail and possessing good alpha/numeric data entry skills with minimal errors. - Intermediate proficiency in Microsoft Office Suite products including Word, Outlook and Excel plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software. - Ability to travel on occasion for company meetings. Requirements - High school diploma or equivalent education (GED) required. - Registered Pharmacy Technician with a state board of pharmacy. - A minimum of 2 years of experience in operational pharmacy benefits (health plan or PBM), clinic setting, high volume call center, or retail pharmacy. - eClinicalWorks or similar EMR experience. - Experience working with geriatric patients or a medication adherence program is a plus. - Bilingual in English/Spanish highly desired. Company Description ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities.
Role Description Are you passionate about serving patients in an inspiring work environment alongside talented people? Get moving with OCR! With over 50 years in business, we are the premier provider of orthopedic care in Colorado, Wyoming, and Nebraska. Our organization continues to grow and we are looking for individuals who share our mission. The Authorization/Benefits Coordinator primarily manages all aspects of the surgical benefits process including: - Verifying patient benefits - Contacting patients regarding eligibility and payment - Entering surgical charges and receipts - Following up on aging receivables - Resolving any issues related to this process This position works closely with insurance coordinators to develop knowledge, communicate changes or adjustments, and resolve issues with patient accounts. This position will have options for remote work and has the potential to work out of other OCR locations. Qualifications - High school diploma or equivalent is required. - Minimum 1 year experience in the insurance or medical industry or equivalent experience with collections in a business/accounting department. - Knowledge of medical terminology preferred. Requirements - Determines patient out-of-pocket expenses using estimates provided by surgery authorization personnel and patient insurance plan. - Notifies patients of determined expenses and establishes payment arrangements per guidelines and department protocols. - Provides prompt support for check-in personnel regarding insurance eligibility issues. - Maintains complete, accurate and up-to-date notes in patient account regarding surgical benefits and pre-authorizations. - Responds to insurance companies’ requests for information in a prompt and professional manner. - Corrects errors in assigned accounts and communicates other account errors to the respective Insurance Coordinator. - Identifies problem accounts on a timely basis and communicates them to supervisor for further action. - Follows up on all denials, claim suspensions, and severe reductions in reimbursement promptly. - Demonstrates consistent collection work by monitoring patient accounts for payment of surgical agreements. - Routinely audits coding and demographical data on visit tickets to ensure the accuracy of claims. - Acts as backup for surgery authorization personnel on an as needed basis. - Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor. - Other duties as assigned. Benefits - Medical, Dental, & Vision coverage - Life and AD&D Insurance - Short- and Long-term disability coverage - Retirement savings and profit-sharing plan participation - Employee Assistance Program - Paid Holidays & Paid Time Off - Company-sponsored events - Annual merit increases *Benefit eligibility is dependent on employment status, and a waiting period may apply.
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