Shields Health Solutions

Pharmacist

• Collaborate with clinic teams to deliver hands-on patient care.
• Process prior authorizations, resolve insurance issues, and support financial assistance.
• Educate patients on pharmacy services and assist with specialty and retail prescriptions.
• Maintain accurate documentation and contribute to process improvements.

Pharmacy Liaison

Therapist

• Review and evaluate medication orders for accuracy, appropriateness, and safety.
• Provide medication counseling to patients, addressing questions and concerns.
• Collaborate with healthcare providers to develop and monitor medication therapy plans.
• Conduct patient care assessments and identify opportunities for optimizing drug therapy.
• Participate in interdisciplinary collaboration and provide clinical recommendations.
• Monitor and manage drug interactions, adverse effects, and therapeutic outcomes.
• Maintain accurate patient records and documentation of interventions.
• Stay current with developments in pharmacotherapy and contribute to the development of clinical protocols.
• Ensure compliance with all state and federal regulations and accreditation standards.
• Assist in the training and mentoring of new hires, pharmacy students and pharmacy liaisons (technicians).

Clinical Pharmacist – Therapy Management

• Ensure Patient Outreach Coordinators consistently communicate with patients compliantly and convey the culture of kindness and value of the hospital-based pharmacies
• Coach Patient Outreach Coordinators on calling best practices, conversational techniques including how to listen, understand, respond, and confirm patients’ concerns about their care, pharmacy needs, and socioeconomic situations
• Complete audits of team in DialPad, TelemetryRX application, Electronic Medical Records, and other required systems to ensure effective communications with patients, efficient workflow, and compliant conversations with potential patients of hospital partner pharmacies
• Work with a high sense of urgency to manage, monitor, and facilitate any issues and/or escalations related to Outreach Coordinators with hospital partners
• Establish efficient workflows between Patient Outreach Coordinators, Onboarding Specialists and liaison team via collaboration with clinical integration team, on site managers, and Patient Outreach Management
• Manage all aspects of ADP, PTO, and Time Reports for team members
• Provide front line supervision and ongoing coaching and performance management to Patient Outreach Coordinators
• Monitoring and acting all forms of communications between Patient Outreach and other clinical and operational teams as needed
• Manage Telemetry application, email, Microsoft teams communications up to company policy
• Work with on site management at hospital partners for any collaboration calls, such as quarterly calls, kick off calls, as needed calls
• Patient Outreach team meetings: creating agendas, running meeting, follow up
• Hospital Management meeting: calls with on site manager to review current status, identify areas for improvement, and areas of success
• Record keeping/notes of all collaboration calls and team meetings
• Providing guidance/assistance/troubleshooting in daily tasks for Patient Outreach team members as requested by Patient Outreach Coordinators and Onboarding Specialists
• Review and address any concerns with Patient Outreach team, and hospital partners as needed
• Provide insight to various teams across company for growth and development opportunities as needed
• Work with various teams for special projects
• Report on hiring needs based on implementation roll outs
• Assist in interviewing, and onboarding new Patient Outreach Coordinators and Onboarding Specialists including coordinating access requests and trainings
• Investigate research needed for data analytics team, contracting team as needed
• Report to Manager of Patient Outreach

Pharmacy Technician Outreach Supervisor

• Work with insurance companies to obtain medication approvals.
• Use pharmacy systems to enter data, run test claims, and manage follow-up actions.
• Document patient needs, authorization status, and assistance efforts across systems and EMRs.
• Communicate with prescribers to ensure accurate and appropriate prescriptions.
• Maintain detailed records of all patient interactions.
• Assist patients with insurance claims and medication adherence over the phone.
• Partner with pharmacists and liaisons to support coordinated patient care.
• Research information to support decisions and operational improvements.
• Manage and update data in relevant databases.
• Identify issues, recommend solutions, and participate in process improvement initiatives.
• Maintain confidentiality and ongoing professional development.
• Perform additional duties as needed; minimal travel may be required.

Pharmacy Technician – Prior Authorization

• Coordinate and process medication refills, including data entry and claim adjudication
• Place outbound refill calls and assist patients through the refill request
• Respond to and resolve inbound patient and provider inquiries
• Clarify prescription orders with pharmacists or clinical staff
• Maintain and update patient and prescription data in software systems
• Spot trends, recommend improvements, and support process-improvement initiatives
• Partner with cross-functional teams to deliver a seamless patient experience
• Maintain confidentiality and uphold high-quality service standards

Pharmacy Technician, Refill Calls

Supervisor

• Directly lead and manage a team of Patient Support Associates to ensure medication adherence through refill management OR timely and accurate prior authorization and financial assistance support to assist patients in obtaining medication.
• Proactively manage support in assigned hospitals and/or clinics to ensure patients receive medications on-time
• Lead and manage a Patient Support team to ensure all service level goals are met and patients receive the highest quality care
• Manage all aspects of ADP, Paid Time Off (PTO), and Time Reports for team members
• Complete audits of team in supported systems required to ensure efficient workflow
• Manage responsiveness to new request in supported systems
• Provide front-line supervision and ongoing coaching and performance management to Patient Support team
• Monitor and acting on all forms of communications between the Patient Support team and other clinical teams as needed
• Work with on-site management at hospital partners for any collaboration calls, such as quarterly calls, kick off calls, as needed calls
• Patient Support team meetings: create agendas, run meeting, follow-up
• Hospital Management meeting: calls with on-site manager to review current status, identify areas for improvement, and areas of success
• Record keeping/notes of all collaboration calls and team meetings
• Provide guidance/assistance/troubleshooting in daily tasks for Patient Support team members as requested by team
• Review and address any concerns with Patient Support team, and hospital partners as needed
• Establish efficient workflows between the Patient Support team and liaison team via collaboration with clinical integration team and on-site managers.
• Provide insight to various teams across company for growth and development opportunities as needed
• Work with various teams for special projects
• Report on hiring needs based on implementation roll outs
• Assist in interviewing, and onboarding new team members
• Coordinate access requests for new hires
• Coordinate training with Clinical Training Team
• Absorb overflow work in times of short staffing or excess workload
• Investigate research needed for data analytics team, contracting team as needed
• Manage on site pharmacy relations and workflows through some/all of the following: reversal of claims, delivery slips, coordination of care, phone calls
• Use discretion and maintain confidentiality of highly sensitive and private data.
• Ability to lead, manage, and motivate team members that are in both remote working environments and/or at on-site Shields hub locations

Prior Authorization Supervisor

• Directly lead and manage a team of Patient Engagement team members to ensure timely and accurate refill support to assist patients in obtaining medication
• Proactively manage support in assigned hospitals and/or clinics to ensure patients receive medications on time
• Ensure all service level goals are met and patients receive the highest quality care
• Manage all aspects of ADP, Paid Time Off (PTO), and Time Reports for team members
• Complete audits of team members in supported systems to ensure efficient workflow
• Manage responsiveness to new requests in supported systems
• Provide front-line supervision and ongoing coaching and performance management to the Patient Engagement team
• Monitor and act on all forms of communication between the Patient Engagement team and other clinical teams as needed
• Work with on-site management at hospital partners for any collaboration calls, such as quarterly calls, kick off calls, as needed calls
• Facilitate team meetings which include creating agendas, facilitating meetings, and following up
• Facilitate hospital management meetings which include calls from on-site managers to review status, identify areas for improvement, and areas of success
• Record keeping/notes of all collaboration calls and team meetings
• Provide guidance/assistance/troubleshooting in daily tasks for Patient Engagement team members as requested by team members
• Review and address any concerns with the Patient Engagement team and hospital partners as needed
• Establish efficient workflows between the Patient Engagement team and liaison team via collaboration with clinical integration team and on-site managers
• Provide insight to various teams for growth and development opportunities as needed
• Work with various teams for special projects
• Report on hiring needs based on implementation roll outs
• Assist in interviewing, and onboarding new team members
• Coordinate access requests for new hires
• Coordinate training with Clinical Training Team
• Absorb overflow work in times of short staffing or excess workload
• Investigate research needed for data analytics team and contracting team as needed
• Manage on site pharmacy relations and workflows through some/all of the following: reversal of claims, delivery slips, coordination of care, phone calls
• Use discretion and maintain confidentiality of highly sensitive and private data
• Ability to lead, manage, and motivate team members that are in both remote working environments and/or at on-site Shields hub locations
• Reports to Director or Manager of Patient Engagement
• Support and coordinate after-hour coverage, including occasional weekends during high volume weeks

Supervisor, Patient Engagement

• Lead, coach, and manage a team of Patient Support Associates to ensure medication adherence, prior authorization completion, and financial assistance support
• Provide ongoing performance management, training, and mentorship
• Manage staffing, scheduling, PTO, and time reporting (ADP)
• Step in to support workload during peak or short-staffed periods
• Ensure patients receive medications on time and without barriers
• Partner with hospital/clinic stakeholders through regular meetings and collaboration calls
• Maintain strong working relationships with pharmacy and clinical teams
• Monitor and ensure achievement of service level metrics and quality standards
• Conduct audits, oversee system workflows, and manage responsiveness to incoming requests
• Establish and optimize workflows between Patient Support, liaison teams, and clinical integration teams
• Identify and implement operational improvements and best practices
• Support data, analytics, contracting, and special projects
• Provide troubleshooting, guidance, and issue resolution for team members and partners
• Assist with hiring, onboarding, training coordination, and system access setup
• Maintain confidentiality of sensitive patient and business data

Patient Support Supervisor

Data Entry

• Perform benefits investigations and verify insurance coverage
• Utilize approved tools, EMR systems, and Pharmacy Dispensing Systems (PDS)
• Review patient medical records to confirm medication regimens
• Accurately document investigation outcomes
• Collaborate with team members to support high-quality patient care
• Identify trends, resolve issues, and recommend process improvements
• Participate in ongoing operational and performance improvement initiatives
• Maintain confidentiality of sensitive patient and organizational information
• Stay current through professional development and training
• Complete additional duties as assigned

Pharmacy Technician – Eligibility Data Entry Specialist

Director

• Oversee daily operations of outreach teams and ensure alignment to strategic initatives.
• Develop and implement scalable operational strategies that enhance and align to continued growth.
• Lead and facilitate strategic discussions with regional and senior leadership teams to identify challenges, develop solutions, and drive continuous operational improvements.
• Monitor and manage budgets, ensuring operational performance targets are met while maintaining a patient-centered approach.
• Drive continuous process improvement initiatives by assessing workflows, identifying inefficiencies, and implementing best practices across the broader team.
• Provide visibility and career advancement opportunities through leadership training, succession planning, and mentorship programs.
• Build, inspire, and develop a high performing, engaged team by providing clear direction, motivation, and professional growth opportunities.
• Establish and maintain strong relationships with Regional Vice Presidents (RVPs) and their regional leadership teams to ensure health system and clinic satisfaction.
• Serve as a trusted partner and subject matter expert to hospital and clinic leadership, helping resolve operational challenges and drive service excellence.
• Ensure consistent adoption of best practices across all CO operations, driving alignment with Shields Health Solutions' mission and values.

Director of Patient Outreach – Enrollment

• Oversee daily operations related to Specialty Pharmacy refill management and inbound pharmacy call operations
• Develop and implement scalable operational strategies that enhance service delivery, productivity, and patient support outcomes
• Lead and facilitate strategic discussions with regional and senior leadership teams to identify challenges, develop solutions, and drive continuous operational improvements
• Monitor and manage budgets, ensuring operational performance targets are met while maintaining a patient-centered approach
• Drive continuous process improvement initiatives by assessing workflows, identifying inefficiencies, and implementing best practices across the broader team
• Leverage technology solutions (CRM platforms, automated refill systems, data analytics, and other technology that will drive efficiency and scalability)
• Provide visibility and career advancement opportunities through leadership training, succession planning, and mentorship programs
• Oversee and prioritize work across multiple sites with responsibility for 75+ employees
• Build, inspire, and develop a highly performing, engaged team by providing clear direction, motivation, and professional growth opportunities
• Ensure consistent adoption of best practices across all EC operations, driving alignment with Shields Health Solutions' mission and values

Director of Patient Engagement – Refills, Inbound Pharmacy Team

Manager

• Lead end-to-end execution of large-scale specialty pharmacy and healthcare transformation programs
• Own program strategy, governance, and execution across multiple concurrent implementations
• Act as central PMO lead, driving alignment across clinical, IT/EMR, AI, 340B, payer, and operational workstreams
• Partner with executive stakeholders (internal and external) to drive decision-making and ensure successful outcomes
• Oversee go-live readiness, execution, and post-launch optimization
• Identify and solve complex operational challenges, balancing short-term milestones with long-term scalability
• Build and refine playbooks, frameworks, and standardized processes to scale implementations across the organization
• Drive continuous improvement, innovation, and adoption of new technologies (including AI/automation)

Senior Manager – Business Transformation

• Lead end-to-end implementation of specialty pharmacy and healthcare programs
• Own project plans, timelines, risks, and execution (PMO leadership)
• Drive cross-functional workstreams (clinical, IT/EMR, AI, 340B, payer)
• Partner with stakeholders to ensure successful go-lives and adoption
• Build scalable processes, playbooks, and continuous improvements

Business Transformation Manager

Revenue Operations

• Serve as a senior revenue cycle leader and trusted advisor to health system executives, internal leadership team members, finance leaders, pharmacy leadership, and operational stakeholders on home infusion reimbursement performance, risks, and strategic opportunities.
• Develop and execute the revenue cycle strategy for home infusion services, aligning operational performance, payer reimbursement requirements, cash acceleration, margin protection, and scalable growth objective.
• Build and maintain strong relationships with health system executives and senior operators to ensure alignment on revenue cycle expectations, performance commitments, issue resolution, and long-term partnership goals.
• Lead revenue cycle transformation initiatives across home infusion, including workflow redesign, automation, analytics, standardization, system optimization, and operating model improvements.
• Manage core home infusion RCM functions, including billing, follow-up, denial management, collections, cash posting, and AR resolution.
• Oversee reimbursement workflows for both pharmacy and medical benefit claims, including coordination of infusion drug, nursing, supplies, and ancillary service billing as applicable.
• Monitor and improve key performance indicators such as DSO, aging, clean claim rate, first-pass yield, denial rate, cash collections, write-offs, and authorization-related reimbursement leakage.
• Lead payor-specific billing and follow-up strategies for commercial, Medicare, Medicaid, managed Medicaid, and other government and contracted payors.
• Partner with intake, clinical, and authorization teams to ensure accurate patient onboarding, coverage verification, prior authorization, and financial clearance processes.
• Ensure timely identification, escalation, and resolution of billing edits, denials, underpayments, and documentation deficiencies.
• Review AR trends and develop action plans to accelerate collections and reduce preventable denials.
• Collaborate with client finance teams on cash forecasting, month-end close support, bad debt analysis, and reserve considerations related to revenue cycle performance.
• Maintain strong knowledge of home infusion reimbursement rules, including payer policy requirements, Medicare and Medicaid billing considerations, and site-of-care reimbursement dynamics.
• Support implementation and optimization of billing systems, workflow automation, reporting tools, and process controls.
• Supervise, coach, and develop RCM staff; establish productivity standards and accountability mechanisms across the team.
• Serve as a cross-functional partner to contracting, operations, and compliance on reimbursement issues, audit responses, and process redesign initiatives.

Senior Manager, Revenue Cycle Management – Home Infusion

Call Center Representative

• Proactively coordinate medication refills including data entry and pharmacy claim adjudication
• Make outbound patient refill phone calls and complete the patient refill request
• Answer, resolve and triage inbound inquiries
• Clarify prescription orders with pharmacist and/or clinician as appropriate
• Identify medications requiring special storage and/or handling such as hazardous medications and/or refrigerated medications
• Manage, organize, and update relevant data using database applications
• Apply observations and recommendations regarding operational issues, increased productivity, and quality standards
• Identify trends and resolve problems by recommending improvements and implementing changes
• Actively participate in process improvement initiatives
• Act as a value-added business partner to stakeholders throughout the organization
• Protect organization's value by maintaining confidential information
• Update knowledge by participating in educational opportunities, reading professional publications, and maintaining networks
• Ability to be flexible on shift times: typical shift times: 8:30AM to 5:00PM but can differ based on time zone and clinic operating hours (standard hours to be discussed at time of hire and overtime and weekend hours may be required as needed)
• Other duties and/or responsibilities may apply