3rd Party Operations Supervisor

PharMerica; Louisville (KY); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Competitive Pay

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Flexible Schedule

Paid Time Off

Tuition Reimbursement

DailyPay

401k

Pet Insurance

Job summary

PharMerica is seeking a Supervisor, 3rd Party Analysts to direct the analyst team and coordinate transactions between PharMerica and third-party payers. The role interfaces with multiple departments to ensure accurate plan and claim data and supports operational improvements.

The ideal candidate has strong leadership,communication skills, and experience in pharmacy billing or health data analysis, with a focus on improving processes and ensuring regulatory compliance.

Qualifications

• Associate's degree or equivalent combination of education and experience.
• Experience in supervisory or leadership roles in healthcare billing.
• Experience with pharmacy or health data analysis is preferred.

Responsibilities

• Establish analyst goals, metrics, and quality assurance with the 3rd Party Operations Manager.
• Provide guidance and leadership to staff and clearly define roles.
• Coordinate with staff, payers, and internal departments to resolve issues.
• Create and maintain SOPs and training plans for analysts.
• Manage attendance, time sheets, and payroll reporting.
• Lead regular team meetings to review performance and progress.

Skills

Leadership

Confidentiality

MS Office

Communication

Ambiguity management

Workload management

Long term care billing

Education

Associate's degree

Bachelor's degree

Tools

AS400

Job description

Our Company

PharMerica

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 a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!

Schedule

Monday - Friday

8:00am - 4:30pm

Required

Weekends and on-call rotations required.

Benefits

• 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.

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

• 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. Follow us on Facebook , Twitter , and LinkedIn.

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.