Describe the primary goals, objectives or functions or outputs of this position.
The Patient Care Coordinator Supervisor provides leadership, support, and supervision for the
Patient Care Coordinator team within Pharmacy Solutions. This individual is a subject matter
expert on commercial pharmacy, major medical, and government insurance plans, prior
authorizations, appeals, and alternate coverage referrals. The supervisor ensures that all day to day activities of the team operate smoothly and seamlessly to provide the best customer
experience for patients. This position is responsible for ensuring all performance metrics,
workload deliverables and customer services activities are completed in alignment with a high
touch business model.
Key Responsibilities Include :
- Supervise and oversee Patient Care Coordinators (PCCs) responsible for assisting patients. Work proactively with staff and cross-functional groups to develop creative solutions to challenging patient access issues regarding prior authorization, pharmacy coordination, and denied coverage requests to ensure patient care.
- Monitor work flow and adjust workload and staffing requirements to ensure that all
activities are addressed in a timely and efficient manner.
- Monitor calls and perform case reviews to ensure accuracy of information, adherence to
policies, and excellent customer service. Provide additional coaching and training to
individuals as needed. Meet regularly with direct reports to provide direct feedback on
their performance and progress against goals. Responsible for writing and communicating performance reviews.
- Perform administrative tasks such as work hour scheduling, attendance monitoring and
counseling, vacation request scheduling, and overtime scheduling. Participate in the hiring process and handle all employee issues for their direct reports.
- Use effective coaching and management techniques to maintain a highly motivated and
interactive work staff.
- Meet or exceed department standards relative to performance metrics. Take responsibility and accountability for the day-to-day execution of tasks and is responsible for providing periodic progress reports on goals and metrics. Elevate issues as appropriate.
- Consistently build and maintain collaborative relationships cross-functionally to ensure a
seamless customer experience for patients.
- Identify process improvements to increase operational efficiencies and develop action plan for execution. Assist with the implementation of new projects and products within the
- Understand and comply with all required training, including adherence to federal, state, and local pharmacy laws, HIPAA policies and guidelines, and the policies and procedures of Pharmacy Solutions and AbbVie.
- Perform additional tasks, activities, and projects as deemed necessary by management.
- Bachelor’s degree or Associate Degree in health sciences or business preferred. Comparable or relevant experience will be considered.
- Meet Pharmacy Technician licensure and certification requirements by start date in
accordance with the Illinois Pharmacy Practice Act.
- 3-5 years of experience in the healthcare industry with knowledge in reimbursement, billing, prior authorization, appeals, and specialty pharmacy operations
- 1-2 years supervisory experience in a call center, large physician, managed care, or
healthcare insurance setting desired
- Demonstrate strong, accurate technical skills. Detail oriented. Thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, prior authorization and appeal filings, and specialty pharmacy operations.
- Proven leadership and coaching skills. Demonstrated ability to lead and participate within a team, manage multiple priorities and meet associated timelines while maintaining accuracy.
- Professional written and verbal communication skills to interact with and build and maintain relationships with all levels of the organization. Maintains a positive service image at all times even when dealing with challenging issues and unsatisfied customers.
- Proven organizational, time management, and problem solving skills, elevating to management when appropriate.
- Skilled with the use of the Microsoft Office suite of products and the ability to use and
effectively learn and navigate other computer systems.
- Knowledge of applicable regulations and standards affecting pharmaceutical products
(e.g. CFR 210/211, cGMP).
Equal Opportunity Employer Minorities/Women/Veterans/Disabled