Manager Third Party Operations (Help Desk and TP Systems)

Albertsons•Boise, ID

About The Position

Job Title: Manager, Third Party Help Desk & Systems Reports to: Director, Managed Care Operations Department: Managed Care Operations Third Party Help Desk & Systems Job Responsibility: Project Management for Third Party Operations Systems enhancements, Third Party Help Desk Improvements and Third Party cross-functional support Manages IT Support Desk Relationship and support ticket ownership Responsible for Third Party Operational procedures posted on Daily Dose Direct oversight of Third Party Help Desk call center, reporting, process improvement and support for scheduling and staffing. Point person with Managed Care teams and outside departments on reports, edits, training, and various other tasks Manage relationship and communications with vendors Ensure all pharmacies can process through switch vendor and escalate necessary outages Review work of direct reports to ensure accuracy and provide feedback Responsible for reviewing department processes to ensure maximum efficiency in all required tasks Provide reports and updates to Management regarding staff’s individual and team performance Proactively identify potential editing opportunities to maximize margin/minimize loss via vendor processing system reporting Identify potential vendor processing system enhancements to assist with reporting capabilities Confirm reimbursement based on contracted rates and follow up with PBM/Plan contacts when noncompliance is identified R eview and identify legal and audit risks that may occur based on vendor system reporting available Communicate effectively, including very detailed follow-up, with all areas of the business, vendors, and PBM/Plan contacts Identify, create, and manage editing to ensure pharmacy compliance with PBM requirements to prevent future audit recoupments

Requirements

H.S. Diploma
Advanced computer skills – Microsoft Office (Excel, Access, Outlook etc.)
Ability to work in a team environment and adapt easily to constant change
Math skills at a proficient level
Strong communication skills, both written and verbal
Ability to manage time efficiently and stay organized
Ability to follow verbal or written instruction
Strong decision-making abilities
Detail oriented
Knowledge of third party processing and NCPDP industry standards preferred

Nice To Haves

Pharmacy Technician preferred
Third Party/Managed Care experience preferred
Management or Training experience preferred
Helpdesk experience preferred
Knowledge of third party processing and NCPDP industry standards preferred

Responsibilities

Project Management for Third Party Operations Systems enhancements, Third Party Help Desk Improvements and Third Party cross-functional support
Manages IT Support Desk Relationship and support ticket ownership
Responsible for Third Party Operational procedures posted on Daily Dose
Direct oversight of Third Party Help Desk call center, reporting, process improvement and support for scheduling and staffing.
Point person with Managed Care teams and outside departments on reports, edits, training, and various other tasks
Manage relationship and communications with vendors
Ensure all pharmacies can process through switch vendor and escalate necessary outages
Review work of direct reports to ensure accuracy and provide feedback
Responsible for reviewing department processes to ensure maximum efficiency in all required tasks
Provide reports and updates to Management regarding staff’s individual and team performance
Proactively identify potential editing opportunities to maximize margin/minimize loss via vendor processing system reporting
Identify potential vendor processing system enhancements to assist with reporting capabilities
Confirm reimbursement based on contracted rates and follow up with PBM/Plan contacts when noncompliance is identified
Review and identify legal and audit risks that may occur based on vendor system reporting available
Communicate effectively, including very detailed follow-up, with all areas of the business, vendors, and PBM/Plan contacts
Identify, create, and manage editing to ensure pharmacy compliance with PBM requirements to prevent future audit recoupments