DaVita Rx is seeking a Supervisor of Insurance Operations (11:30 PM to 7:30 AM) for our insurance rejection teams at our state-of-the-art pharmacy in Orlando-FL. The primary focus of this position is to ensure that adjudication rejections, insurance verification, and therapeutic interchange request are processed in an efficient, timely, accurate manner and in complete accordance with all applicable laws, regulations and company policies. The successful candidate will lead a team of insurance coordinators and pharmacy technicians to serve the needs of our patients.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.
Manage the employee hiring process; develop or update job descriptions; develop performance expectations, identify essential functions, skills and abilities required; assign work shifts; complete position requisition forms; and ensure compliance with company processes for interview and selection of employees;
Motivate and coach teammates to achieve continuous improvement and operational excellence
Assist in the development and maintenance of teammate training, reference and audit tools
Assist in the development and implementation of Standard Operating Procedures (SOPs) and job aids for all functions performed
Coordinate with the management team to plan production staffing requirements on a daily, weekly and quarterly basis
Develop a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow within the first 6 months
Propose creative solutions to manage daily workflow and temporary labor shortages
Maintain absolute compliance to all applicable regulations via a thorough practice of documentation and organizational skills
Prioritize work to meet daily and competing deadlines.
Create and maintain relationships with the DaVita Rx Pharmacy operational Directors, Managers and Chief Pharmacists
Demonstrates "leadership by example" in projecting a positive attitude, and involvement in DaVita Rx teammate activities
In assigned area of leadership, this position will demonstrate expert knowledge and training for employees, as well as serve as initial response for problem or process review
Ensure all DaVita teammate management responsibilities are met including but not limited to ePCNs completed in timely manner; teammate relations issued handled appropriately; personnel files maintained according to DaVita policies; PDRs completed in timely manner; teammates informed of opportunities and Davita programs such as 'Triple Crown,' 'We Are Here,' etc.
Know, understand, follow, implement, and communicate DaVita Rx and DaVita company policies and procedures including teammate guidelines through the use of written policy manuals and/or in-service education
Review and approve time cards and ePTO requests of direct reports for payroll
Understand basic wage and hour laws, federal, state and local laws and regulations, Medicare, and legislation affecting employment in dialysis and pharmacy services
Perform other duties as assigned by Pharmacy and Operational Management
Attend staff meetings, teleconferences, and patient care conferences as needed
Maintain absolute compliance to all applicable regulations
5 to 8 years of leadership experience, with a strong emphasis on people management and coaching employees is required
Strong call center and operations experience highly preferred; ability to lead and manage a call center and operations environment of teams up to 50 teammates
Experience and knowledge of electronic claims adjudication process, commercial insurance, Medicare Part D and Medicaid programs reimbursement rules, prior authorization requirements and regulations in the pharmaceutical industry
Healthcare experience is preferred
Bachelor’s degree Business Administration, Health Care Administration, or similar discipline is strongly preferred. We will consider candidates with a less-relevant educational background in lieu of applicable experience
The shining star in this role should have:
Strong experience and success in creating high performance work environments
Effective communication skills
Solutions oriented; ability to solve issues proactively and effectively
Excellent organizational and leadership skills are required. Must be able to manage team performance; train or provide adequate training for employees; coach, counsel and motivate employees; evaluate employee performance; address issues or performance concerns
Demonstrated ability to organize, direct and perform high level supervisory duties in a manner conducive to full performance and high morale is required
Candidate must be a strong self-starter who is capable of operating in a dynamic and fast changing environment
Must have the ability to work in a high production environment, meet deadlines, and demonstrate critical thinking skills
Ambitious, energetic, and willing to learn and grow
Must have strong PC skills (MS Office)
DaVita is an equal opportunity/affirmative action employer. As such, DaVita makes hiring decisions solely on the basis of qualifications and experience, and without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.