Customer Service Supervisor PBM
United States of America
Full Time
1 day ago
Visa Sponsor
Key skills
Pharmacy Benefit Management (PBM)Managed careHealthcare call center operationsPharmacy environment knowledgeCertified Pharmacy Technician (CPhT)Call center supervisionPerformance metrics analysisHIPAA complianceAILeadershipCommunication
About this role
Marpai Administrators LLC is a technology company transforming the Third Party Administration sector with AI-powered solutions. The Customer Service Supervisor, PBM will lead a team of agents to provide high-quality service regarding prescription drug coverage, ensuring compliance with regulations and enhancing customer satisfaction.
Responsibilities:
- Supervise team: Guide the team through complex member inquiries regarding drug formularies, tier structures, and copays. Supervise the investigation and resolution with members, pharmacies and prescribers of rejected pharmacy claims, coordinating eligibility overrides and technical point-of-sale errors
- Enforce compliance with regulatory requirements: Monitor and train teams on strict adherence to HIPAA regulations and other applicable regulations
- Monitor Key Performance Indicators (KPI) and Service Level Agreements (SLA): Ensure the team meets contractual SLAs
- Training and Coaching: Analyze trends of issues to identify, training gaps, performance issues, and create a plan to address the gaps and recommend solutions as needed. Provide coaching and critical conversations to direct reports for developmental and correctional issues
- Quality assurance and audits: Complete monthly call monitoring. Review monthly scorecard with individuals on team, identifying trends that need to be addressed as well as kudos for jobs well done
- Handles overflow for calls, chat, and emails as needed especially during peak
- Maintain and develop Standard Operating Procedures
- Other duties as required
Requirements:
- 2+ years of experience in a PBM, managed care, healthcare call center, or pharmacy environment
- 3 years minimum call center experience
- 3+ years in a supervisory or leadership role in a call center
- Strong leadership and team management skills
- Excellent communication, both verbal and written
- Problem-solving and conflict resolution skills
- Ability to analyze performance metrics and use data to improve team effectiveness
- Encourage and support accountability and engagement, including sharing of information, ownership and successes with others
- Consistently communicate expectations to clients and internal team members
- Capability to manage service recovery as necessary
- Active Certified Pharmacy Technician (CPhT) designation or state pharmacy technician license is highly preferred