Pharmacy Member Services Supervisor

AdventHealth • Apopka, FL

291d

About The Position

The Member Services Supervisor performs a wide range of supportive duties to assist the pharmacy in preparing and dispensing medication so that patients receive consistent care. This position coordinates the day-to-day activities of a team of remote, hybrid and onsite support staff and monitors member outreach, prescription volume ready for fulfillment and incoming faxes. The member services supervisor works directly with members and other organizational departments to facilitate communication to our members regarding clarifications or delays with their prescription order. This position hires, supervises and supports training for all team members of the member services department and is required to understand all pharmacy processes and positions excluding Pharmacist's duties. Works only under the supervision of a registered Pharmacist and does not perform duties that can only be legally performed by a registered pharmacist.

Requirements

• High School Diploma GED or equivalent.
• 2 pharmacy technician experience, preferably in retail or mail-order pharmacy.
• Intermediate to advanced skill set in MS Office: Word, Excel, Outlook and Microsoft Teams.

Nice To Haves

• Previous experience in a call center environment.
• Understanding and experience with a Pharmacy Benefit Management (PBM), or managed healthcare service organization (MCO).
• Leadership experience.

Responsibilities

• Maintains confidentiality of patient, employee, medical staff, departmental and administrative information.
• Responsible for in depth understanding of pharmacy's services and is able to articulate to staff to ensure pharmacy processes are followed and stated goals are met with increased safety and efficiency.
• Supports departmental and organizational Mission through appropriate use of resources, aiding team members and management, accepting work or scheduled assignments and acts as a role model to the team to provide suggestions and creative ideas for performance improvement.
• Communicates with the manager regarding work priorities to coordinate daily workflow/task assignments and provides feedback regarding requests, projects, and assignments as appropriate.
• Collaborates with other pharmacy leaders and continually examines existing processes and communicates fresh solutions for improving overall efficiency and safety.
• Monitors team's workflow queues and adjusts resources as needed to achieve daily production goals; supports team as needed by assisting in fax team and print processing duties.
• Maintains an awareness of patient profile notes and reads and follows through with all necessary actions.
• Plays a role in maintaining effective records, adding new relevant information to the patient's profile to be communicated to the entire staff as necessary.
• Thoroughly understands the AdventHealth employee health prescription plan and supports the prescription benefit account team by offering support and education when communicating with members or physician's offices any questions regarding formulary coverages, eligibility, prior authorization, or general plan guidelines.
• Supports benefit related service activities, including but not limited to, the oversight and use of appropriate operational overrides ensuring that the plan guidelines are followed appropriately.
• Maintains an awareness of plan related initiatives, quarterly prescription plan formulary coverage updates and offers support to staff and organizational team, as necessary.
• Communicates effectively with any customer or team member regarding prescription questions or follow-up.
• Leaves adequate and understandable notes in member's profile for any issue that needs to be communicated to other staff members.
• Serves as a point of escalation for calls requiring a higher degree of expertise or discretion to resolve customer issues and ensures timely resolution.
• Communicates with department Manager, any areas of concern for future service.
• Plays an active role in the Customer Service Triage process, ensuring those that are speaking with customers have all the resources and education needed to provide accurate and helpful information to all callers.
• Monitors the main Rx Plus Pharmacy contact center wallboard, ensuring all member calls are answered in a timely manner, deploys backup as necessary; takes phone calls as appropriate.
• Works with organizational leaders to support and achieve abandonment rate, average speed to answer, and other performance indicators within stated goals.
• Conduct extensive interviews for new hire recruitment ensuring the right person is hired based on qualifications and skillset as they would fit best within the organization.
• Conducts monthly one on ones with direct reports, reviews call quality indicators and overall performance.
• Works with department leaders to develop content and lead out on weekly team huddles.
• Works with department manager to answer any departmental questions and/or clarifications, adjusting workflow as necessary.
• Works within mandated registered pharmacy technician scope of practice guidelines.

Benefits

• Benefits from Day One
• Paid Time Off from Day One
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

What This Job Offers

• Job Type: Full-time
• Industry: Hospitals
• Education Level: High school or GED