Oncology Pharmacy Adjudication Lead

Onco360

Waltham (MA)

On-site

USD 54,000 - 66,000

Full time

6 days ago

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Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with match

Paid time off

Paid holidays

Quarterly incentive bonuses

Tuition reimbursement

Life insurance

Short-term disability

Long-term disability

Job summary

Onco360 is seeking a Pharmacy Adjudication Supervisor to lead the claims adjudication team and ensure accurate processing of pharmacy claims. The role emphasizes collaboration with pharmacy operations and compliance, with a focus on reducing rejections and improving patient satisfaction.

The ideal candidate has pharmacy adjudication experience, leadership skills, and a solid understanding of insurance contracts.

Qualifications

Required: High School Diploma or GED; knowledge of insurance and applicable regulations.
Desired: Associate or Bachelor's Degree; Certified Pharmacy Technician; Specialty pharmacy experience

Responsibilities

Supervise adjudication staff and lead in a positive team environment.
Assist Director of Pharmacy Operations in day‑to‑day operations and implement new procedures.
Recruit, onboard, develop, and train staff; apply performance coaching and corrective actions as needed.
Manage daily activity, monitor workflow, and prepare Pulse reports for leadership.
Handle escalations and ensure accurate, timely adjudication and outreach to patients/providers.