Service Delivery Manager

AcariaHealth; New York (NY); On-site; USD 100,000 - 125,000; Full time

Job summary

A leading healthcare organization seeks a Service Delivery Manager for its Medical Management/Health Services team. In this role, you will be pivotal in resolving specialty pharmacy issues for 28 million members, ensuring high-quality service and operational efficiency. You will monitor trends, collaborate with internal teams, and mentor new hires, all while benefiting from a competitive salary and comprehensive benefits package.

Benefits

Health insurance

401K

Tuition reimbursement

Paid time off

Flexible work schedules

Qualifications

• 5+ years’ experience in pharmacy operations.
• Knowledge of pharmacy processes.
• Experience with ScriptMed software preferred.

Responsibilities

• Serve as the liaison between account management and specialty pharmacy operations.
• Investigate and resolve concerns regarding specialty dispenses.
• Analyze payer complaints to develop action plans.

Skills

Pharmacy operations

Problem-solving

Communication

Analysis

Education

Associate’s degree in related field

Job description

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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose Serve as the primary point of contact and liaison between account management and specialty pharmacy operations. Responsible for facilitating the resolution of specialty pharmacy escalated issues from the account management team's payer clients.

• Investigate and provide resolution to payer concerns regarding specialty dispenses to members.
• Analyze and monitor payer complaints to identify trends; develop and implement action plans to maintain high levels of quality service.
• Collaborate with account management and specialty pharmacy operations departments to investigate and resolve all issues.
• Expedite urgent orders and follow through to dispense.
• Document and provide status updates on outstanding issues.
• Monitor high risk members and prescriptions to mitigate risk.
• Work with internal teams to enhance processes based on expertise and client insight.
• Mentor, develop and train newly hired team members as assigned.
• Performs other duties as assigned.
• Complies with all policies and standards
  
  

Education/Experience Associate’s degree in related field or equivalent experience. 5+ years’ experience in pharmacy operations (intake and insurance verification, call center). Knowledge of pharmacy operational processes (intake and insurance verification, call center, pharmacy dispensing). Experienced ScriptMed user.Pay Range $22.79 - $38.84 per hour

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Project Management and Information Technology

• Industries

  Hospitals and Health Care and Insurance

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