Service Delivery Manager

Centene Corporation

3d•$23 - $40

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Serve as the primary point of contact and liaison between account management and specialty pharmacy operations. Responsible for facilitating the resolution of specialty pharmacy escalated issues from the account management team's payer clients. Investigate and provide resolution to payer concerns regarding specialty dispenses to members. Analyze and monitor payer complaints to identify trends; develop and implement action plans to maintain high levels of quality service. Collaborate with account management and specialty pharmacy operations departments to investigate and resolve all issues. Expedite urgent orders and follow through to dispense. Document and provide status updates on outstanding issues. Monitor high risk members and prescriptions to mitigate risk. Work with internal teams to enhance processes based on expertise and client insight. Mentor, develop and train newly hired team members as assigned. Performs other duties as assigned. Complies with all policies and standards

Requirements

Associate’s degree in related field or equivalent experience.
5+ years’ experience in pharmacy operations (intake and insurance verification, call center).
Knowledge of pharmacy operational processes (intake and insurance verification, call center, pharmacy dispensing).
Experienced ScriptMed user.

Responsibilities

Serve as the primary point of contact and liaison between account management and specialty pharmacy operations.
Responsible for facilitating the resolution of specialty pharmacy escalated issues from the account management team's payer clients.
Investigate and provide resolution to payer concerns regarding specialty dispenses to members.
Analyze and monitor payer complaints to identify trends; develop and implement action plans to maintain high levels of quality service.
Collaborate with account management and specialty pharmacy operations departments to investigate and resolve all issues.
Expedite urgent orders and follow through to dispense.
Document and provide status updates on outstanding issues.
Monitor high risk members and prescriptions to mitigate risk.
Work with internal teams to enhance processes based on expertise and client insight.
Mentor, develop and train newly hired team members as assigned.
Performs other duties as assigned.
Complies with all policies and standards