Program Director

Elusa Health•Maitland, FL

4d•Onsite

About The Position

The Program Director is responsible for managing all client communications with executive level client leadership. This position will also oversee all program operations, specific to pharmacy and medical benefits investigations, the prescription fulfillment process, and the Transfers Department.

Requirements

Direct pharmaceutical and patient services experience required
Ability to organize and plan the activities of subordinates, and to delegate appropriately.
Superior level of customer service as well as understanding the department operations.
Highly effective in working objectively with a diverse group of people and must demonstrate communication, organizational, administrative and office skills.
Experience to include accounting and billing software, and the ability to learn the Company’s software system.
Must be a team player willing to accept and promote organizational goals and function with minimal supervision.
Ability to respond to common inquiries from customers, employees, or senior management.
Ability to work with mathematical concepts such as statistical inference. Ability to apply concepts such as percentages, ratios, and proportions in practical solutions.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Maintain HIPAA patient confidentiality.

Nice To Haves

Bachelor of Science degree in Health Care Management, and/or completion of certification courses, preferred.
5+ years’ experience in Health Care Management, preferred.

Responsibilities

Manages adherence to all KPIs and SLAs specific to the client program.
Maintains all program specific contracting, SOPS, and business rules.
Ensures completion of pharmacy cases daily, and all other operations-related work.
Monitors daily volumes to include calls/cases/chats.
Ensures the implementation of processes to measure, assess, and improve the performance of the Program Support and call center activities.
Develops, reviews and suggests changes to the Program Support policies and procedures, as needed.
Oversees record keeping to ensure all information is accurate and complete, and manages the flow of up-to-date information between billing department and other parts of the Company, such as accounts receivable, accounts payable, and customer service.
Communicates as required with manufacturer sales representatives and leadership.
Coordinates and participates in conference calls with manufacturer partners, as needed.
Generates and analyzes reports specific to the Programs’ operations and employee performance.
Provides orientation and on-the-job training for subordinates, ensuring that the authority and responsibilities for each position are clearly defined and understood.
Directs department staff members.
Arranges for performance evaluation of each member of department staff; establishes quarterly and annual performance goals, and monitors progress toward these goals on a consistent basis.
Delegates authority as necessary to ensure that all responsibilities of this position are fulfilled in a timely and accurate manner.
Ensures ongoing compliance with all laws and regulations; ensures that the department meets or exceeds accreditation standards; and implements “best practices” in all departmental activities.
Participates in the Company’s Quality Improvement (QI) Program as requested by the QI Manager(s).
Participates in Company committees when requested.
Pursues continuing education programs appropriate to job responsibilities.
Performs other duties as assigned by VP of Operations.
Must exhibit excellent skills in the following areas: verbal/written communication, computer/data entry/software proficiency, interpersonal and relationship-building skills, self-discipline, attention to detail, and the ability to maintain strict confidentiality.
Must demonstrate effective communication skills by conveying necessary information accurately, listening effectively and asking questions when clarification is needed.
Must be able to be depended upon to plan and organize work effectively and ensure its completion.
Must be able to demonstrate reliability by arriving to work on time and taking breaks in expected timeframes.
Must have timely communication with direct supervisor regarding late arrival, calling out sick, emergency situations, etc., as well as requesting approval for time off well in advance.
Must meet all productivity requirements in expected timeframe or deadline.
Is expected to represent the organization professionally at all times.
Must be able to demonstrate initiative and strive to continually improve processes and relationships.
Perform other duties assigned.