3rd Party Operations Supervisor

BrightSpring Health Services; Louisville (KY); Sur place; USD 65 000 - 90 000; Plein temps

Avantages offerts par ce poste

Competitive Pay

Health & Dental Insurance

Disability Insurance

Flexible Schedule

Paid Time Off

Tuition Reimbursement

Daily Pay

401k Plan

Pet Insurance

Sign-On Bonus

Résumé du poste

PharMerica is seeking a 3rd Party Operations Supervisor to lead billing and claims activities within a non-retail pharmacy environment. The role partners with the 3rd Party Operations Manager to drive performance, policy adherence, and process improvements across departments.

Experienced supervisors with strong MS Office skills, confidentiality, and knowledge of long-term care billing will excel. This is a full-time position with standard M-F hours and on-call rotations as needed.

Qualifications

• Requires an associate degree or technical certification or equivalent work experience.
• Bachelor's degree preferred.
• 2+ years supervisory or leadership experience.
• 5+ years experience in a Pharmacy Technician role or billing in healthcare.
• 3+ years experience with pharmacy or health data analysis.

Responsabilités

• Lead billing and claims operations with clear goals and quality metrics.
• Supervise analysts; provide guidance and staff development.
• Maintain relationships with staff, payers, and internal departments.
• Coordinate and troubleshoot claim and payer issues.
• Develop and update standard operating procedures and training plans.
• Oversee attendance and payroll timekeeping; ensure policy compliance.
• Conduct regular performance reviews and improve processes to reduce revenue loss.
• Serve as SME for internal billing system and industry relations.

Connaissances

Leadership

Confidentiality

MS Office

Communication

C-level presentation

Ambiguity navigation

Workload management

Long-term care billing

Formation

Associate's degree

Bachelor's degree

Outils

AS400

Description du poste

3rd Party Operations Supervisor

Job Details

ID: 2026-196514

Line of Business: PharMerica

Position Type: Full-Time

Company

PharMerica

Overview

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

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. If your passion is service excellence and top-quality care

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. 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.