Full-Time
Prior Authorization Technician
Pharmacy Technician
Shields Health Solutions
1,001-5,000 employees
Specialty pharmacy services for health systems
No salary listed
Remote in USA
Remote
Bachelor's
 Medical, Clinical & Veterinary (1) |
|---|
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- Years of Experience: Required 1+ years as a Pharmacy Technician
- Education: High school diploma or GED required
- Licensure/Certification: If the candidate lives in a state that does not require registration (i.e. Delaware, Hawaii, New York), candidate agrees to obtain a state license within 6 months of employment and must be nationally certified (PTCB or NHA) at time of hire; in all other cases, PTCB or NHA is highly preferred but not required (must be obtained within 9 months of employment)
- Solid computer skills: proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management; data entry and computer skills will be evaluated through an assessment as part of the pre-employment process
- Communicate directly with insurance companies to facilitate medication approvals
- Navigate pharmacy operating systems to input data, adjudicate test claims, and develop action plans for follow-up
- Communicate effectively across databases, electronic medical records, and email systems to document patient concerns, prior authorization status, and financial assistance needs
- Review prescriptions with physicians’ offices to ensure optimal patient care
- Maintain complete and accurate records of patient communications
- Assist patients with managing their pharmacy insurance claims
- Collaborate closely with pharmacists and pharmacy liaisons to deliver a coordinated, high-quality patient care experience
- Communicate directly with patients via phone to support medication adherence and compliance
- Research and analyze information to support strategic decision-making
- Manage, organize, and update relevant data within database systems
- Apply observations and recommendations to improve operations, productivity, quality, and customer service standards
- Identify trends, resolve issues, recommend improvements, and implement changes
- Participate actively in process improvement initiatives
- Act as a value-added business partner to stakeholders across the organization
- Protect organizational value by maintaining confidentiality of information
- Maintain professional knowledge by participating in educational opportunities, reading professional publications, and engaging in professional networks and organizations
- Minimal in-state or out-of-state travel may be required
- Perform other duties as assigned
Shields Health Solutions provides integrated specialty pharmacy services for health systems to improve patient outcomes and drive growth. It collaborates with 75 health systems, including academic medical centers and community hospitals across 47 states, to deliver medication management, patient support programs, and care coordination for patients with chronic and complex diseases. The company works by partnering with clinicians and healthcare providers to manage specialty medications, optimize clinical outcomes, and make high-cost therapies more accessible and affordable. What sets Shields apart is its extensive network of health-system partnerships and its focus on therapy management and coordination within the hospital ecosystem, rather than operating as a standalone retail pharmacy. The goal is to help health systems expand access to specialty care, improve patient outcomes, and grow through integrated pharmacy services.
Company Size
1,001-5,000
Company Stage
Growth Equity (Non-Venture Capital)
Total Funding
$3.5B
Headquarters
Quincy, Massachusetts
Founded
2012
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Simplify's Take
What believers are saying
- June 9, 2026 Baptist Health partnership expands Shields into Jacksonville specialty pharmacy.
- March 3, 2026 outcomes report showed growth across nearly 80 health systems.
- January 13, 2026 Foundation Health deal adds AI prior-authorization workflows.
What critics are saying
- Accredo competes directly after Evernorth's 2025 $3.5 billion preferred investment.
- Any payer steering away from Shields' limited-distribution access crushes referral volume.
- If payer steering worsens, Shields becomes a thin-margin pass-through and loses health-system contracts.
What makes Shields Health Solutions unique
- Shields spans 80% of limited-distribution drugs and most payers nationally.
- Its integrated model lowers total cost of care 13% across health systems.
- Sycamore and Evernorth backed Shields' 2025 private spinout, reinforcing capital access.
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Benefits
Hybrid Work Options
Annual Performance Bonus
Growth & Insights and Company News
6 month growth
↑ 24%1 year growth
↑ 24%2 year growth
↑ 24%Shields Health Solutions partners with Columbus Regional Health to enhance patient access to Specialty Pharmacy Services. The partnership will support patients through personalized care, medications, and coordination STOUGHTON, Mass. & COLUMBUS, Ind.-(BUSINESS WIRE)-Shields Health Solutions (Shields), the premier specialty pharmacy accelerator in the country announced a new partnership with Columbus Regional Health (CRH), a leading health system serving a 10-county area in south central Indiana, and its first health system partner in the state of Indiana. This enhanced collaboration is designed to better support patients who rely on specialty medications to treat complex conditions such as cancer, multiple sclerosis, and autoimmune diseases. By expanding support services, the partnership will help ensure comprehensive, coordinated care for more than 8,000 patients managing chronic conditions. Upon the initial launch of the program, CRH's Specialty Pharmacy will service cardiology, pulmonology, oncology, and gastrointestinal patients, with the goal of continued expansion into additional disease states. It will also strengthen care coordination across CRH's provider network by integrating Shields' proven specialty pharmacy care model and deep expertise. Through this partnership, patients will benefit from personalized support services, including assistance navigating insurance coverage and financial assistance programs. These services are intended to reduce out-of-pocket costs, improve medication adherence, and ensure timely access to critical therapies. "Our partnership with Columbus Regional Health reflects the health system's commitment to delivering exceptional care for every patient," said Michael Ham, CEO of Shields Health Solutions. "We look forward to working alongside Columbus Regional as it expands specialty pharmacy services and its impact on complex patients throughout southern Indiana." "CRH is committed to delivering exceptional care and service for all patients," said Matt Hotek, Director of System Pharmacy Services at Columbus Regional Health. "We're excited to collaborate with organizations that share our commitment to delivering results and putting patients at the center of everything we do." Shields currently partners with nearly 75 health systems around the country, helping patients to reduce co-pays, promptly receive medication delivery, and improve medication adherence. About Shields Health Solutions Shields Health Solutions (Shields) is the premier specialty pharmacy accelerator in the country. The Shields Performance Platform, an integrated set of solutions, services and technology, is intentionally designed to elevate payer and drug access for specialty pharmacies, elevate health outcomes for complex patients, and elevate growth throughout the entire health system. As the foremost experts in the health system specialty pharmacy industry, Shields has a proven track record of success including access to over 80 percent of all limited distribution drugs (LDDs) and most (health insurance) payers in the nation; and a clinical model proven to lower total cost of care by 13%. In partnership with nearly 75 health systems across the country through national-scale collaboration, Shields has a vested interest in delivering measurable clinical and financial results for health systems. For more, visit its blog and follow HealthTech HotSpot LLC on social media, @ShieldsRX, LinkedIn, Facebook, and YouTube. About Columbus Regional Health Columbus Regional Health is an independent health system based in south central Indiana, and a proud member of the Cleveland Clinic Connected program. CRH holds a 107-year history as a premier healthcare provider in the state, and is a top employer in its flagship community of Columbus, Indiana. CRH is comprised of more than 2,600 employees, 225 physicians on medical staff and 250 volunteers. Columbus Regional Hospital, the system's anchor facility, is a 225-bed not-for-profit, providing emergency and surgical services and comprehensive care in numerous specialty areas. Columbus Regional Health Physicians offers a network of primary and specialty care physicians. For Shields Health Solutions Jeff Cramer Director, Communications and Corporate Affairs For Columbus Regional Health Kelsey DeClue Public Relations Coordinator April 22nd, 2026 April 21st, 2026
Shields and Foundation Health partner to bring AI to a rapidly evolving specialty pharmacy landscape. As the specialty pharmacy landscape rapidly changes, Shields Health Solutions is taking a thoughtful approach to innovation. In Becker's Hospital Review, Shields shares why it partnered with Foundation Health to develop AI-enabled workflows designed to strengthen operational efficiency and future-ready pharmacy models. Read the full article at Becker's Hospital Review.
Shields Health Solutions, Lakeland Regional Health collaborate to enhance patient access to specialty pharmacy care. The partnership will support patients through personalized care, medications, and coordination. STOUGHTON, Mass. & LAKELAND, Fla. (November 12, 2025) - Shields Health Solutions (Shields), the premier specialty pharmacy accelerator in the country, has partnered with Lakeland Regional Health, one of Florida's leading healthcare providers, to improve access to specialty medications for patients managing chronic and complex health conditions. This enhanced collaboration is designed to support patients who rely on specialty medications to treat conditions such as cancer, multiple sclerosis, and autoimmune diseases. It will also strengthen care coordination across Lakeland Regional Health's provider network by integrating Shields' care model and expertise in specialty pharmacy. "Lakeland Regional Health is known for delivering compassionate, high-quality care to patients across Central Florida," said Michael Ham, CEO of Shields Health Solutions. "We're proud to support their teams by expanding access to specialty medications and helping patients manage complex therapies more affordably and effectively." Through this partnership, patients will benefit from personalized support services, including help navigating insurance coverage and financial assistance programs, which aim to reduce out-of-pocket costs, improve medication adherence, and ensure timely access to critical therapies. The initial focus of the collaboration will be on oncology and rheumatology with plans to expand into additional specialties over time. Shields currently partners with nearly 80 health systems nationwide, helping patients receive medications faster, reduce co-pays, and improve health outcomes. "At Lakeland Regional Health, we are committed to removing barriers to care and ensuring our patients have access to the treatments they need," said Ana Kalman, SVP, Chief Information Officer, Chief Operating Officer and Medical Center COO of Lakeland Regional Health. "Partnering with Shields allows us to enhance our specialty pharmacy services and deliver even greater value to our community." For more information, visit www.shieldshealthsolutions.com.
Evernorth Health Services announced on Tuesday a $3.5 billion investment in Shields Health Solutions, a specialty pharmacy management company.
Cigna's unit, Evernorth Health, will invest $3.5 billion in Shields Health to enhance its specialty pharmacy business. This investment follows Shields' transition to a private company after Sycamore Partners acquired its former parent, Walgreens Boots Alliance, for $10 billion. Evernorth, which operates Accredo, aims to meet the growing demand for specialty medications. The investment is in preferred stock and won't impact Cigna's 2025 profit forecast.