理赔助理II

As a pharmaceutical support industry leader, UBCis devoted toempowering health solutions for a better tomorrow. We takeprideinimprovingpatient outcomes andadvancing healthcare.At UBCwe provide services to enhance the entire drug development process and commercialization lifecycle - From clinical trial support to real-world evidence generation.

Embark on a rewardingcareer journey with UBC! Growyour career while making a meaningfulimpacton theworldaround you.UBCfosters a culture built on our Core Values being: Collaborative, Conscientious, Curious, Consultative, and Compassionate. We believe in aninclusive workplacethat fosters creativity.

If you are seeking a career that willchallenge, inspire,andrewardyou, join us atUBC!

Brief Description:

The Supervisor – Program Management is responsible for managing the day-to-day activity of the program(s) and supervises a team of employees. Position may be client facing. Works with the Program Manager to develop policies, procedures, and the business work plan for the program. This position performs hiring, scheduling, training, and development of direct reports. Recognizes, recommends, and implements operational improvement.

Provides direction, coordinates and supervises the activities of the operational team using established policies and procedures. Sets priorities for the team to ensure task completion, coordinates work activities with other supervisors and managers. Work is reviewed for soundness of judgment and overall quality and efficiency

Specific job duties:

• Manage daily activities per the scope of work, program, and standard operating procedures within the contracted budget.

• Ability to understand and actively enforce program guidelines and project specific procedures (PSPs).

• Manage day-to-day activity of the program operation, including supervision of staff.

• Assist in developing program metrics and identifying efficiencies

• Monitor program metrics to ensure adherence to program SLAs

• Resolve complex cases.

• Participate in interviewing prospective employees, evaluating current employees, and train employees as needed.

• Create new and/or update training materials and PSPs as needed.

• Translate decisions and discussions into documented workflow processes.

• Develop current employees and track their compliance to quality, service, and program standards.

• Conduct, at minimum, monthly team meetings with meeting agendas and minutes.

• Assist with presentation of program information to internal and external customers.

• Handle escalated and unresolved issues that may require deviation from standard procedures or require extensive research for resolution

• Coordinate with manager(s) to set goals and expectations for the team to ensure task completion.

• Other duties as assigned.

• Ability to travel as needed

• Actively participates in in-person and virtual meetings/events (internal and external)

Supervisory Responsibility:

1 –20 Direct Reports

Skills and Qualifications:

• Associate or Bachelor’s degree in relevant discipline or equivalent work experience

• Five (5) or more years of relevant experience in pharmacy benefit management, specialty pharmacy or patient support/access (HUB) services preferred

• Three (3) or more years of relevant experience in pharmacy and/or medical benefit verifications, prior authorization and/or appeals required.

• Customer service experience required

• Call center experience preferred

• Strong computer skills with specific aptitude in Microsoft Office

• Excellent verbal and written communication and presentation skills

• Strong analytical and problem-solving skills

• Ability to lead and develop a successful team required

• Ability to work a flexible schedule

Benefits:

At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally.

Here are some of the exciting perks UBC offers:

• Remote opportunities

• Competitive salaries

• Growth opportunities for promotion

• 401K with company match

• Tuition reimbursement Flexible work environment

• 20 Days PTO (Paid Time Off)

• Paid Holidays

• Employee assistance programs

• Medical, Dental, and vision coverage

• HSA/FSA

• Telemedicine (Virtual doctor appointments)

• Wellness program

• Adoption assistance

• Short term disability

• Long term disability

• Life insurance

• Discount programs

UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.

Originally posted on Himalayas