Patient Benefits Supervisor

Patient Benefits Supervisor

Onco360 Pharmacy is seeking a Patient Benefits Supervisor in New Hyde Park, NY. This role is based in Louisville, KY and involves overseeing patient prescription benefits, including demographics, medical and pharmacy coverage, and authorization requirements. The ideal candidate should have advanced program knowledge and experience in pharmacy or benefit verification.

• Responsibilities:
• Oversee activities related to proper loading and investigation of patient prescription benefits.
• Provide quality control by examining cases completed by team members.
• Supervise and lead a team to maintain a positive working environment, minimize employee relations issues, and reduce turnover.
• Communicate effectively with pharmacy and corporate teams, and resolve issues.
• Assist in day-to-day pharmacy operations and implement new procedures.
• Evaluate, coach, and utilize performance management practices for BV staff.
• Manage and report on daily activity of vertical team members, monitor workflow, and escalate No-Go trends or contract-related claim rejections.
• Handle escalations for difficult BV cases/questions and ensure accurate and timely completion.
• Communicate payor benefit programs and policies to the BV/Onboarding team and offer support for system functionality questions.
• Work with Pharmacy Technician Manager and/or Director of Pharmacy Operations on other responsibilities, projects, and initiatives.

Qualifications

• Education/Learning Experience:
• High School Diploma or GED.
• Associates or Bachelor’s Degree preferred, especially in pharmacy or related fields.
• Certified Pharmacy Technician (PTCB) certification desired.
• Specialty pharmacy experience preferred.

• Experience:
• 4+ years pharmacy or benefit verification experience, with 5+ years preferred.
• Previous leadership experience in a supervisory role.

• Skills/Knowledge:
• Advanced knowledge of pharmacy insurance and benefit verification.
• Understanding of PBM and Medical contracts.
• Knowledge of Medicare, Medicaid, and commercial insurance.
• Experience with NCPDP claim rejection resolution.
• Coordination of benefits and NDC medication billing.
• Excellent interpersonal and communication skills.
• Ability to work independently, manage multiple tasks, and meet deadlines.
• Leadership skills and the ability to conduct research and be resourceful.

• Licenses/Certifications:
• Registration with the Board of Pharmacy as required by state law.
• Certified Pharmacy Technician (PTCB) certification desired.
• Advanced Certified Pharmacy Technician with completion of Billing and Reimbursement certification desired.

• Behavior Competencies:
• Independent worker, good interpersonal skills, excellent verbal and written communications skills.
• Able to work independently, manage time efficiently, and be flexible.
• Detail-oriented and great time-management skills.
• Leadership skills.