Prior Authorization Supervisor

Shields Health Solutions; United States; Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Equal employment opportunities

Ongoing training and support

Job summary

Shields Health Solutions is hiring a Patient Support Supervisor to provide leadership to the Patient Support team. This role involves ensuring medication adherence through effective management of associates and maintaining high service quality.

The ideal candidate will possess strong operational management skills, leadership experience in pharmacy or healthcare, and a proactive approach to team development. A Bachelor’s degree is preferred, alongside pharmacy technician experience.

Qualifications

• 3+ years of pharmacy technician experience required, preferably in Specialty Pharmacy.
• Preferred leadership experience, possibly in a Team Lead role.
• Registered pharmacy technicians in the state of employment are preferred.

Responsibilities

• Lead and manage a team of Patient Support Associates.
• Ensure service level goals are met for medication adherence.
• Provide ongoing coaching and performance management to team members.

Skills

Strong communication presence

Operational management skills

Ability to lead and motivate

Proficient in Microsoft Office

Education

High School / GED

Bachelor’s degree preferred

Tools

Pharmacy dispensing systems

EMR systems

Job description

Location: Stoughton and Phoenix Area Preferred (other locations considered based on unique situations)

Shields is seeking an experienced person who loves to work with and lead people, has strong management skills, who is highly motivated self-starter who is looking for a challenging career with a fast-growing company in specialty pharmacy management services. Applicants should be results-oriented with a positive outlook and a clear focus on high quality. A natural forward planner who critically assesses their own performance. The ideal candidate should have front-line employee management experience with a background in pharmacy or healthcare. Applicant should be service-oriented, motivational in their style and have a clear focus on performance accountability and employee development. The applicant must be able to work as a member of a close-knit team.

A Patient Support Supervisor is a key leadership position supporting Shields Health Solutions Patient Support team. This position will provide day-to-day leadership for a significant portion of Patient Support Center and will be responsible for leading a team of Patient Support team members. This person is primarily responsible to ensure either/both of the following: Manage all responsible work of assigned sites/clinics and ensure service level metrics are reached in accordance with contract requirements. The leader is responsible for ensuring the adoption and continuity of best practices, providing ongoing support, coordinating coverage, coaching, performance management and professional development of the team, and any other support team members.

Key Responsibilities

• Directly lead and manage a team of Patient Support Associates to ensure medication adherence through refill management OR timely and accurate prior authorization and financial assistance support to assist patients in obtaining medication.
• Proactively manage support in assigned hospitals and/or clinics to ensure patients receive medications on-time
• Lead and manage a Patient Support team to ensure all service level goals are met and patients receive the highest quality care
• Manage all aspects of ADP, Paid Time Off (PTO), and Time Reports for team members
• Complete audits of team in supported systems required to ensure efficient workflow
• Manage responsiveness to new request in supported systems
• Provide front-line supervision and ongoing coaching and performance management to Patient Support team
• Monitor and act on all forms of communications between the Patient Support team and other clinical teams as needed
• Work with on-site management at hospital partners for any collaboration calls, such as quarterly calls, kick off calls, as needed calls
• Patient Support team meetings: create agendas, run meeting, follow-up
• Hospital Management meeting: calls with on-site manager to review current status, identify areas for improvement, and areas of success
• Record keeping/notes of all collaboration calls and team meetings
• Provide guidance/assistance/troubleshooting in daily tasks for Patient Support team members as requested by team
• Review and address any concerns with Patient Support team, and hospital partners as needed
• Establish efficient workflows between the Patient Support team and liaison team via collaboration with clinical integration team and on-site managers.
• Provide insight to various teams across company for growth and development opportunities as needed
• Work with various teams for special projects
• Report on hiring needs based on implementation roll outs
• Assist in interviewing, and onboarding new team members
• Coordinate access requests for new hires
• Coordinate training with Clinical Training Team
• Absorb overflow work in times of short staffing or excess workload
• Investigate research needed for data analytics team, contracting team as needed
• Manage on site pharmacy relations and workflows through some/all of the following: reversal of claims, delivery slips, coordination of care, phone calls
• Use discretion and maintain confidentiality of highly sensitive and private data.
• Ability to lead, manage, and motivate team members that are in both remote working environments and/or at on-site Shields hub locations
• Reports to Director or Manager of Patient Support Center

Licensure / Certification

• Experienced pharmacy technicians who are registered with the State of employment and also nationally certified as a CPhT. Should certification need to be obtained for a particular state or updated at the time of employment, the applicant will commit to obtaining the required certification within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements.
• Required 3+ years of pharmacy technician experience (3-5+ years’ experience preferred in Specialty Pharmacy)
• Strongly preferred leadership experience (i.e. Team Lead or equivalent type role or experience where you have led other team members even if they do not directly report to you)

Education

• Preferred Education: High School / GED (Bachelor’s degree is preferred or actively working toward degree)
• Preferred Training: Training on leadership/management theory and its practical applications in the workplace (on-line / classroom / self-study)

Skills

• Strong communication presence with ability to influence without formal authority
• Ability to make decisions and negotiate with more senior leaders that results in a mutual and positive outcome
• Excellent leadership and interpersonal skills
• Ability to effectively train and inspire Patient Support team leaders to be more independent
• Strong operational management skills and able to evaluate trends and identify opportunities for program improvement
• Ability to manage projects and see them through effective completion
• Manage and prioritize workload while meeting deliverables and expectations
• Ability to effectively train employees, lead by example and use motivational techniques to improve/maintain employee engagement
• Patient-centered, organized, high-integrity, motivational, attention to detail, dependable, quality focus, empathetic, good listener/communicator, a good teacher, able to lead a group of individuals
• Ability to use discretion and maintain confidentiality of highly sensitive and private health information
• Strong communication skills, highly proficient in Microsoft Office particularly Excel and Word
• Knowledge and skills using Pharmacy dispensing or EMR systems (knowledge of the Willow, Qs1, and RX30 software system a plus) and able to identify relevant information with a focus on quality is also desirable.
• Proficient in excel using basic formulas, data manipulation, graph creation, and other moderately advanced excel skills
• Possess strong organizational skills
• Remote positions not in a Shields core location (Stoughton, Phoenix): Willingness to travel up to 20% if needed to meet job requirements

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.