Supervisor, Patient Access

Responsibilities

• Supervise and oversee patient access specialists responsible for coordinating review of all application documents
• Conducts insurance investigations when applicable
• Affords patients and HCPs an assessment of their financial information and provides an outcome status
• Maintains oversight of workload and staffing requirements to ensure timely and efficient case addressing
• Monitors and adjusts workload and staffing requirements to ensure all cases are addressed in a timely and efficient manner
• Achieves established KPIs and quality goals
• Performs administrative tasks such as work hour scheduling, attendance monitoring, and counseling
• Schedules vacation requests and overtime allocations
• Handles all employee issues for their 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
• 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
• Assists on special projects within job scope to provide process optimization when requested by management

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