TruHealth

The provider will assess medical and mental health needs for long-term care residents to develop and implement proactive care plans. They will also prescribe medications, order diagnostic tests, and ensure clinical compliance with federal and state regulations.

The Pharmacy Operations Coordinator oversees pharmacy benefit manager activities and ensures compliance with CMS regulatory requirements. They act as a primary liaison between the plan and the PBM while managing formulary requirements and supporting departmental audits.

The Utilization Review Nurse assesses the medical necessity and quality of healthcare services through pre-service, concurrent, and retrospective reviews. They provide clinical support to ensure members receive appropriate medical services in compliance with regulatory guidelines.

Provide personalized, coordinated healthcare to seniors in long-term care facilities to improve quality of life and prevent hospitalizations. Responsibilities include assessing medical needs, prescribing medications, and collaborating with integrated care teams.