Lumicera

Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. .______________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.

USD $69,626.87 - USD $83,888.01 /Yr.

Monday - Friday 8am-5pm

ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

The Manager, Patient Support Services is responsible for the day-to-day leadership/support of the prior authorization specialists and intake specialists. The Manager is responsible for disseminating information through proper channels and ensuring staff comprehension.  This role will assist with analyzing, monitoring, and implementing change as necessary to ensure the staff consistently meet performance metrics and deliver superior service to internal and external goals and guarantees. The Manager will remain informed of current and anticipated client or contractual requirements, changes facing the department and assist or lead interventions or changes as directed.

The Manager, Patient Support Services is responsible for ensuring service levels are met consistently though support of workflow/scheduling practices, training, and staff evaluations. The Manager is responsible for tracking, trending, and reporting Specialist metrics as well as defining and implementing timely plans to resolve opportunities with staff. The Manager will work collaboratively with department trainers and quality analysts to ensure consistency, efficiency, and accuracy in patient interactions. The Manager will ensure staff is adequate, efficient, proficient, and compliant in essential areas and escalate where necessary to make changes/improvements to the workforce and/or its technology resources/tools.

 

Is this you? Find out more below!

How do I make an impact on my team? 

• Participate in setting and enforcing appropriate quality metrics for staff
• Consistently document and retain records of all training, reviews, and feedback with Specialists
• 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
• Assist with the development and maintenance of training resources for staff
• Assist with departmental efforts to ensure high quality new client implementations
• Maintain technical knowledge of the pharmacy processing software, Navitus claims processing software, phone system, quality monitoring and tracking tools, scheduling software, reporting suite, knowledge management application, and other applications and tools as applicable
• Identify and request enhancements that improve efficiency and usability
• Manage processes to be compliant with all requirements including state, federal, and accreditation regulations to include CMS, URAC, ACHC, etc
• Ability to travel between campuses 5% of the time
• Other duties as assigned

What our team expects from you?

• High school diploma, GED, or equivalent required
• Associate or Bachelors degree preferred
• At least 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 industry practices, HIPAA, and applicable data privacy practices preferred
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

Remote

US