Job Description :
This position requires individuals to perform the following duties and work as part of a team :
- 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
- 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 :
The ideal candidate will possess the following skills and experience :
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.