Patient Care Operations Supervisor (Remote)

Navitus Health Solutions, LLC; Accident (MD); À distance; USD 54 000 - 65 000; Plein temps

Résumé du poste

Lumicera Health Services, supported by Navitus, is seeking a results-oriented leader to mentor and manage pharmacy staff in a remote-capable setting. The role focuses on daily workflow management, staff coaching, and adherence to compliance standards.

You will oversee quality metrics, coordinate with staffing agencies, and ensure residents of eligible states can work remotely. This position requires 5% travel and a strong background in managed care or specialty pharmacy.

Qualifications

• High school diploma or GED required; associate or bachelor’s degree preferred.
• CPhT preferred.
• 2 years’ experience in a managed care, specialty pharmacy, customer service, or PBM environment required.
• Experience in a call center environment preferred.
• Direct leadership or coaching / mentoring experience preferred.
• Pharmacy Claim / benefit experience preferred.
• Knowledge of HIPAA and data privacy practices preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Responsabilités

• Ensure daily workload standards are met by understanding current workflow/scheduling needs and plans and ensuring direction to staff supports workflow/scheduling goals.
• Identify and remove barriers that prevent goals from being achieved.
• Review client transitions and changes in volume; ensure scripting and resources are clear.
• Ensure all information impacting staff is shared timely and in an appropriate way.
• Ensure staff comprehension by requesting feedback or through observation.
• Responsible for day-to-day leadership/support of department staff.
• Participate in setting and enforcing appropriate quality metrics for staff.
• Perform periodic quality monitoring of staff.
• Facilitate training/development needs for individuals and department.
• Manage disciplinary process as outlined in department/company policies.
• Consistently document and retain records of all training, reviews, and feedback with Specialists.
• Coach, motivate and develop staff to produce outstanding results.
• Communication and coordination with hiring/temp agencies.
• Act as a prompt escalation resource for calls or department issues or supervisor calls.
• Triage service and technical issues to resolution and educate staff of cause/resolution throughout.
• Conduct appropriate triage to pharmacist staff members, as appropriate.
• Ensure resources available to staff are current and clear through regular maintenance.
• Maintain technical knowledge of the pharmacy processing software, Lumicera’s claims processing software, phone system, quality monitoring and tracking tools, scheduling software, reporting suite, knowledge management application, and other applications and tools as applicable.
• Ability to travel 5% of the time.
• Other duties as assigned.

Connaissances

Leadership

Customer service

Communication

Team coaching

Formation

High school diploma or GED

Associate or Bachelor’s degree preferred

CPhT preferred

Outils

Pharmacy processing software

Lumicera claims processing software

Scheduling software

Reporting tools

Description du poste

Lumicera Health Services, supported by Navitus, is seeking a results-oriented leader to mentor and manage pharmacy staff in a remote-capable setting. The role focuses on daily workflow management, staff coaching, and adherence to compliance standards.

You will oversee quality metrics, coordinate with staffing agencies, and ensure residents of eligible states can work remotely. This position requires 5% travel and a strong background in managed care or specialty pharmacy.