Pharmacy Processing Manager

AdventHealth•Apopka, FL

About The Position

Responsible for all activities regarding state licensed data entry, claims adjudication, prior authorization, pharmacy specialist, and technician quality assurance staff and processes. This position coordinates the day-to-day activities of prescription order intake, technician quality assurance, claims adjudication, copay assistance, prior authorization, and prescription clarification processes to ensure timely completion in accordance with the pharmacy's goals. Additionally, this role hires, trains, and manages team members and supervisors of the processing intake, prior authorization, specialist, and quality teams. In addition, this position resolves difficult issues regarding new and refill prescription orders, prescription turnaround times, and other matters requiring sensitivity and speed. This role is a subject matter expert in State and Federal pharmacy laws and regulations. Acts as a resource for the organization on prescription plan questions and claims adjudication. Maintains strong vendor and customer relationships through professional interactions. Guides staff in executing processes and procedures, offering training and support as needed. Sets daily goals and specific duty assignments for processing team staff. Other duties as assigned.

Requirements

Bachelor's (Required)
Registered Pharmacy Technician (RPhT) - EV Accredited Issuing Body
State Certified Pharmacy Technician (CPhT) - EV Accredited Issuing Body

Responsibilities

Responsible for all activities regarding state licensed data entry, claims adjudication, prior authorization, pharmacy specialist, and technician quality assurance staff and processes.
Coordinates the day-to-day activities of prescription order intake, technician quality assurance, claims adjudication, copay assistance, prior authorization, and prescription clarification processes to ensure timely completion in accordance with the pharmacy's goals.
Hires, trains, and manages team members and supervisors of the processing intake, prior authorization, specialist, and quality teams.
Resolves difficult issues regarding new and refill prescription orders, prescription turnaround times, and other matters requiring sensitivity and speed.
Subject matter expert in State and Federal pharmacy laws and regulations.
Acts as a resource for the organization on prescription plan questions and claims adjudication.
Maintains strong vendor and customer relationships through professional interactions.
Guides staff in executing processes and procedures, offering training and support as needed.
Sets daily goals and specific duty assignments for processing team staff.
Other duties as assigned.