Pharmacy Appeals Team Lead (remote)

Pharmacy Appeals Team Lead (remote)

This is a remote position that is open to any qualified candidate who lives in the United States.

Our Cognizant leadership team is currently seeking an individual to perform as a Team Lead that will have the following duties and work as part of our established pharmacy appeals team. The full-time position is located in the Phoenix, AZ area at our NorTerra facility or 100% remote if outside of the Phoenix area. We are seeking highly motivated healthcare professionals with auditing experience in professional pharmacy appeals area.

Summary :

Meet all KPI Metrics and Deliverables as assigned.

Determines and delegate cases to be worked by Representatives when applicable.

Supervises workload and oversees quality of work by assuring prompt feedback to associates.

Evaluates work of associates. Provides direction and coaching by identifying areas of improvement needed.

Attend all required meetings with clients and provide performance dashboard as necessary.

Implements ongoing training and development of all associates.

Complete weekly and monthly payroll and timecards for associates

Ensure their teams complete all compliance courses as assigned by Cognizant & Client.

Responsible for conducting employee reviews on a monthly basis.

Monitor, evaluate and score transactions against established quality assurance instruments and standards

Participate, as needed, in calibration sessions, communication sessions, and / or creation of communication tools

Supports and communicates business goals, quality standards, processes and procedures and policies

Qualifications :

High level of Pharmacy Appeals processing knowledge and competence as evidenced by a minimum of 3 years' experience in a handling a Pharmacy appeals team.

Ability to plan, organize and implement general business and personnel management practices and equivalent related practical work experience.

Knowledge of Auto / General Liability cost containment programs and proven account management skills a must.

Ability to lead change by addressing points of resistance at the team and / or individual level. The ability to independently evaluate and implement improvement plans.

Demonstrates an understanding of team building theory, and the techniques of continuous quality improvement and how they apply to ongoing activities.

Strong leadership skills include the ability to coach, develop and lead team members towards successful attainment of goals and objectives.

Excellent communication, negotiation, and interpersonal skills, to effectively interact with all levels of an organization both internal and external.

Strong analytical, Critical thinking, and problem-solving ability.

Demonstrated ability to provide consistent superior customer service to customers.

Act as a role model for the unit or office, taking on the work that others avoid and holding self and others accountable for high personal standards. Salary and Other Compensation : Applications will be accepted until November 4, 2025. The hourly rate for this position is between $21.00 - 27.00 per hour, depending on experience and other qualifications of the successful candidate. This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans. Benefits : Cognizant offers the following benefits for this position, subject to applicable eligibility requirements : Medical / Dental / Vision / Life Insurance - Paid holidays plus Paid Time Off - 401(k) plan and contributions - Long-term / Short-term Disability - Paid Parental Leave - Employee Stock Purchase Plan Disclaimer : The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

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Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.