3rd Party Operations Supervisor

BrightSpring Health Services; Louisville (KY); On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Short/Long-Term Disability

Flexible Schedules & PTO

Tuition Reimbursement

DailyPay

401k

Pet Insurance

Job summary

PharMerica, a BrightSpring Health Services affiliate, seeks a Billing & Claims Supervisor to lead the 3rd Party Analyst team and coordinate with payers. The role focuses on setting goals, mentoring staff, and ensuring accurate third-party billing processes.

The position requires strong leadership, analytics, and cross-functional collaboration. Responsibilities include creating SOPs, managing payroll data, and driving improvements in revenue recovery while staying aligned with industry standards

Qualifications

• Supervisory or managerial experience in a healthcare setting.
• Experience with pharmacy or health data analysis is preferred.
• Strong writing and verbal communication skills; ability to present to C-level stakeholders.

Responsibilities

• Lead the 3rd Party Analyst team and coordinate with payers.
• Define goals, performance metrics, and quality assurance standards for the team.
• Maintain SOPs and training plans for analysts.
• Monitor attendance and payroll timekeeping; ensure policy compliance.
• Collaborate with contracting, purchasing, claims, AR, IT and other departments.
• Address third-party billing issues and optimize revenue recovery.
• Represent PharMerica in industry meetings (NCPDP).
• Provide SME guidance on internal claims billing system.

Skills

Leadership

Communication

MS Office (Excel/Word)

Data analysis

Confidentiality

Education

Associate’s degree or equivalent

Bachelor’s degree

Tools

AS400

Job description

Our Company

PharMerica

Overview

Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer anon-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!

Schedule:Monday - Friday8:00am - 4:30pm

Weekends and on- call rotations required

• Competitive Pay
• Health, Dental, Vision & Life Insurance
• Company-Paid Short & Long-Term Disability
• Flexible Schedules & Paid Time Off
• Tuition Reimbursement
• Employee Discount Program & DailyPay
• 401k
• Pet Insurance

Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care.

The Supervisor, 3rd Party Analysts is responsible for the direction and coordination of the 3rd Party Analyst team as well as the coordination of transactions between PharMerica and 3rd party payers. The supervisor will interact with appropriate departments to provide operational support and ensure integrity of third party plan and claim information.

Responsibilities

Billing & Claims Supervisor

• Works in conjunction with the 3rd Party Operations Manager to establish analyst level goals, department wide goals, performance tracking and quality assurance metrics
• Clearly communicates roles and responsibilities of analysts and provides guidance and leadership to staff
• Establishes and maintains professional and effective relationships with staff, peers, payers, and other stakeholders
• Serves as a liaison with staff and payers or internal departments to coordinate and troubleshoot various claim, payer, or other industry related issues
• Works to update, or create and maintain Standard Operations Procedures for the department, including clearly outlining training plans for new or underperforming analysts
• Ensures team assignments are fair and balanced based on analyst’s skills sets
• Manages staff attendance and time sheets for payroll (Day Force) system. Assures staff is meeting attendance policies and reports any variations to Manager
• Holds regularly scheduled meetings with staff to discuss performance metrics and ensure employees are on track to meet their goals
• Enforces disciplinary action and creates performance improvement plans as needed for underperforming staff
• Create and manage reporting opportunities to mitigate third party rejections, reduce revenue loss, and implement process improvements
• Stays up to date on third-party billing requirements and reimbursement guidelines
• Serves as a Subject Matter Expert (SME) for the organization on internal claims billing system and industry relations
• Participates in meetings of the National Council for Prescription Drug Programs (NCPDP), representing the interests of PharMerica and the long term care pharmacy perspective
• Collaborates regularly with Contracting, Purchasing, Claims Processing, Accounts Receivable, Cash Processing, Facility Billing, Admissions, Census, Plan Administration, IT, and other areas of the company
• Ensures communications impacting other areas of the company are distributed properly and timely
• Performs other tasks as assigned
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Qualifications

Education/Learning Experience

• Required: Associate’s degree, relevant technical certification, or equivalent work experience
• Desired: Bachelor’s degree

Work Experience

• Required: 2+ years experience in a supervisory, managerial, or leadership role
• Required: 5+ yrs experience working as a Pharmacy Technician, or in a billing potion within a healthcare setting
• Required: 3+ yrs experience with pharmacy or health data analysis
• Required: 2+ yrs experience working in a Pharmacy, Long Term Care, or Managed Care setting
• Desired: Specialized understanding of billing requirements for Medicare Part D or Medicaid

Skills/Knowledge

• Required: Must be a good leader
• Required: Ability to maintain confidentiality
• Required: Proficiency in MS Office Products (Excel, Word) and basic computer knowledge
• Required: Excellent verbal and written communication skills, and C-level presentation skills
• Required: Ability to effectively navigate ambiguous situations with limited direction
• Required: Able to handle high volume and significant workload
• Required: Familiarity with long term care pharmacy or facility billing practices
• Desired: AS400 computer system experience

About our Line of Business

PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com.

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Additional Job Information

$500 Sign On / Retention Bonus

This is an excellent opportunity to move from a retail to office environment for those who are willing to learn.

Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.