This role provides leadership, support and supervision for a group of agents within assigned territories and ensures quality, compliance and performance are held to the highest standards. This individual is a subject matter expert on commercial pharmacy, major medical and government insurance plans, prior authorizations, medical exceptions, appeals, and access support options within their territory. This role will engage directly with Field Reimbursement Managers (FRMs) and Health Care Provider (HCP) offices within their territory. The ideal candidate will be a strong communicator, able to support patients through clearly educating both FRMs and HCPs to effectively minimize access barriers. The supervisor ensures that all day-to-day activities of the team operate smoothly and seamlessly to provide the best customer experience for physician offices and ultimately patients. This position is responsible for ensuring all performance metrics, workload deliverables and customer services activities are completed in alignment with a high touch business model.

Responsibilities

• Supervise and oversee analysts responsible for prior authorization education and post-benefit verification follow up (Bridge, Patient Access) access assessments in their assigned region.Work proactively with staff and cross-functional groups to develop creative solutions to challenging patient access issues regarding prior authorization and denied coverage requests to ensure patient care.
• Responsible for managing key accounts within assigned region, engaging directly with FRMs and HCPs to effectively minimize access barriers for patients.
• Partner with Leads to monitor workflow and adjust workload and staffing requirements to ensure that all activities are addressed in a timely and efficient manner.
• Monitor calls and perform case reviews to ensure accuracy of information, adherence to policies, and excellent customer service. Provide additional coaching and training to individuals as needed. Meet regularly with direct reports to provide direct feedback on their performance and progress against goals.
• Responsible for writing and communicating performance reviews.
• Perform administrative tasks such as work hour scheduling, attendance monitoring and counseling, vacation request scheduling, and overtime scheduling.
• Participate in the hiring process and handle all employee issues for their direct reports.
• Use effective coaching and management techniques to maintain a highly motivated and interactive workplace.
• Meet or exceed department standards relative to performance metrics. Takes responsibility and accountability for the day-to-day execution of tasks and is responsible for providing periodic progress reports on goals and metrics.
• Provide activity metrics, status updates, and local payor intelligence information to management per established guidelines. Elevate issues as appropriate.
• Consistently build and maintain collaborative relationships cross-functionally to ensure a seamless customer experience for patients and physicians.
• Identify process improvements to increase operational efficiencies and develop action plan for execution. Assist with the implementation of new projects and products within the Pharmacy.
• Understand and comply with all required training, including adherence to applicable federal, state, and local pharmacy laws, HIPAA and privacy policies and guidelines, and the policies and procedures of the business. · Perform additional tasks, activities, and projects as deemed necessary by management.