Supervisor, Patient Access

Responsibilities

• Supervise and oversee patient access specialists responsible for coordinating review of all application documents
• Conducts insurance investigations when applicable
• Affords assessment of patient’s financial information and provides an outcome status to patients and HCPs
• Maintains oversight of workload and staffing requirements to ensure timely and efficient case addressing
• Monitors and adjusts workload and staffing requirements to ensure timely and efficient case addressing
• Ensures all performance metrics and workload deliverables are completed in alignment with business model
• Performs administrative tasks such as work hour scheduling, attendance monitoring, and counseling
• Schedules vacation requests and overtime allocations
• Handles employee issues for direct reports
• Uses effective coaching and management techniques to maintain a highly motivated and interactive work staff
• Meets or exceeds department standards relative to performance metrics
• Provides activity metrics, status updates, and program intelligence to management on an as needed basis
• Responds, investigates, and resolves escalated patient cases and communicates to management as deemed appropriate
• Consistently builds and maintains collaborative relationships cross-functionally to ensure processes are followed according to business rules and policies
• Ensures all patient cases are documented in the CRM in accordance with all business rules and policies

Qualifications

• High school diploma or equivalent required
• Bachelor’s Degree or Associate Degree in health sciences or business preferred
• Comparable or relevant experience will be considered
• Minimum of 3-5 years’ experience within a healthcare provider, PBM, Specialty Pharmacy or Retail/Mail Order Pharmacy setting
• Strong core insurance (Medical and Pharmacy Benefit) knowledge
• Previous leadership in a call center, integrated health care provider, managed care, or healthcare insurance setting desired
• Strong understanding of health care reimbursement channels including; commercial pharmacy, major medical and governmental programs
• Knowledge of online verification systems or similar experience required
• High quality customer service skills
• Maintains a positive service image at all times even when dealing with challenging issues and unsatisfied customers
• Prioritizes organizational, time management, and problem-solving skills, elevating to management when appropriate
• Strong analytical skills preferred
• Ability to express ideas clearly in both written and oral communications
• Strong attention to detail and with the ability to multi-task required