Supervisor Med Auth & Access

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

This individual will report to the BIDMC Pharmacy Ambulatory Manager and will be responsible for the supervision of the BIDMC Specialty Pharmacy Liaison referral team. This individual will be responsible for the day to day operations and oversight of a team of specialty pharmacy liaisons. This individual will not only supervise but will work on patient cases for BIDMC ambulatory clinics. This individual will also work closely with the Director of Pharmacy Ambulatory Services on various projects, implementations and program management.

Job Description:

Primary Responsibilities:

 

1. Assists with day-to-day operations which includes scheduling and coverage of operations (essential)

 

2. Assists with the employee(s) oversight and works closely with leadership to meet departmental goals and performance. (essential)

 

3. Monitors and provide reporting on key performance indicators and meet with staff on a routine basis to have performance discussions (essential)

 

4. Plans, reviews and optimizes workflows ensuring maximization of efficiencies.  Ensures the proper workflow and intakes distribution through departments, and schedules and delegates workload amongst team members. (essential)

 

5. Ensures employee training and quality of work through development of training materials, administration of training and continuous quality control. (essential)

 

6. Ensures consistent communication with staff, patients and providers to ensure proper and timely renewal of authorizations and referrals. (essential)

 

7. Manages direct reports' workload to effectively manage, audit and verify team members' work to ensure information accuracy and productivity. (essential)

 

8. Monitors situations for fraud, waste, and abuse of Medicare/Medicaid benefits and reinforces HIPAA and PHI protocols. (essential)

 

9. Has the authority to direct and support employees daily work activities. Has the direct responsibility to undertake the following employment actions: hiring, termination, corrective action and performance reviews. Direct Reports: less than 10, Indirect Reports: None

 

Required Qualifications:

 

1. 3-5 years related work experience in medication authorization.

 

2. Strong understanding of data & analytics.

 

3. Understanding insurance and adjudication processes. Strong knowledge of 3rd Party Insurance Plans and required PA forms.

 

4. Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.

 

Preferred Qualifications:

 

1. Associates or Bachelor’s degree.

 

2. Supervisor or management experience in pharmacy/authorization setting

 

3. Knowledge of 340B    

 

Competencies:

 

Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.

 

Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.

 

Independence of Action: Ability to set goals and determines how to accomplish defined results with some guidelines. Manager/Director provides broad guidance and overall direction.

 

Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.

 

Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.

 

Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.

 

Team Work: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.

 

Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner.

 

Social/Environmental Requirements:

 

Work requires close attention to task for work to be accurately completed. Intermittent breaks during the work day do not compromise the work.

 

Work is varied every day and the employee needs to be adaptable to respond to these changes and use independent judgment and manage priorities.

 

No substantial exposure to adverse environmental conditions

 

Health Care Status: HCW 3: Regular provision of service in a patient care area. Examples: Unit coordinators, lead coordinator/supervisor, patient liaison, nutrition services, environmental services, registrars, information desks, security, etc- Health Care Worker Status may vary by department

 

Sensory Requirements:

 

Close work (paperwork, visual examination), Color vision/perception, Visual clarity feet, Conversation, Monitoring Equipment, Telephone, Background Noise.

 

Physical Requirements:

 

Light work: Exerting up to 20 pounds of force frequently to move objects. Some elements of the job are sedentary, but the employee will be required to stand for periods of time or move through out the hospital campus

 

This job requires frequent sitting, Keyboard use.

• Additional Job Description

Additional Job Description

 

 

 

 

Pay Range:

$79,040.00 USD - $110,240.00 USD

The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. 

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled