ABOUT

Open is a recruiting partner exclusively dedicated to assembling on-demand, high caliber work-at-home teams.

 

Our unprecedented homesourcing model combines a virtual workforce and management technology platform that fully leverages the many benefits of a national, untethered, work at home solution.  

CONTACT

844.600.5662

info@openhs.com

6400 E. Grant Road

Suite 350

Tucson, AZ 85715

©2017 Open, LLC 

Customer Care

Each customer service call can be an opportunity to drive loyalty and retention. Our professionals are seasoned with both functional and system-specific expertise allowing them to deliver engaging, personalized communication that enrich your brand and your organization – at any time.

  • Member Service Agents

  • Provider Service Agents

  • Multi-Channel Agents

  • Enrollment Agents

  • Quality Analysts

  • Contact Center Supervisors

Claims

Whether you need to provide simple pend resolutions or high-dollar institutional recoveries to your customers, our agents have in-depth experience managing specialized claim processes in all lines of business. Averaging 5+ years of Tier 2 and Tier 3 experience, our talent can work on any claims platform.

  • Claims Processors

  • Claims Adjusters 

  • HICS

  • Claims Auditors 

  • Claims Appeals

  • Recoveries and COB

Sales

Not only do we have licensed agents all across the country, we have licensed agents across all of your lines of business (Commercial, Medicare, and Medicaid) and sectors (MCO, CO-OP, ACO, HIX, etc).

Uniquely qualified to add value to your sales organization, with both functional and system-specific expertise, our seasoned sales agents can help improve your star rating, increase member retention results, and solidify your position as a market leader.

  • Field Sales

  • Member Retention

  • Telesales

Pharmacy Benefit Management  

As a PBM, recruiting and hiring qualified and experienced professionals can be a challenge. We have a diverse network of technically and clinically qualified professionals knowledgeable about the industry and committed to quality of care. Our professionals have a wide range education, licenses and relevant work experience.

 

Our database is filled with an array of pharmacy professionals that understand Part D, MTM, drug utilization review, prior authorization and formulary management that can immediately integrate into your organization.

  • Customer Service Representative

  • Patient Services Coordinator 

  • Patient Care Advocate

  • Clinical Pharmacist

  • Pharmacy Technician 

  • Clinical Programs Pharmacy Tech

Clinical Support

Our nurses are well versed in standards, guidelines and procedures and are highly capable in determining patient eligibility, level of benefits and medical necessity of services. More than ever, it is imperative to evaluate the medical necessity of procedures. Our clinical support professionals can review procedures prior to approval to protect the accuracy of your actuarial analysis.

  • Medical Case Review

  • Prior Authorization Nurse

  • Clinical Admin Coordinator 

  • RN-Appeals and Grievance

  • HEDIS Review

  • Utilization Review

  • Clinical Education Manager

  • Clinical Documentation Improvement

Healthcare Professionals

Create your dream team and elevate the standard of care you provide to your customers