Team Lead, Medicare Part D Operations

hace 4 meses

San Juan, Puerto Rico abarca health A tiempo completo

What you’ll do

In a few words…

Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning...

Providing high quality services to client and beneficiaries is at the core of what we do every day The Pharmacy Benefit Management Operations & Services team is the very heart of Abarca and meets that standard by running services from medication therapy management to price eligibility to government services and beyond. From Prescription Drug Event to Medicare Plan Finder and beyond, our Team Leader Medicare Part D Operations manages all Medicare Part D programs. The Government Programs teams does it all: wrangling financial operations, tracking, and reviewing prescription drug events, handling payor transactions, reporting, audits, regulations, and guidance. 

As a Team Leader Medicare Part D Operations you will lead the Medicare Part D processes, along with a small team. In this critical role you will provide overview on areas such as Prescription Drug Event, claims restacking, true out-of-pocket costs, benefit phases, low income subsidies and plan finder. That’s just naming a few areas where you’ll ensure consistency in quality, alignment with Abarca’s strategies, executing on commitments and ensuring ongoing goals are met. You’ll also provide guidance and coaching to your team in order to ensure your mentorship brings them much needed support.

The fundamentals for the job…

Lead the team responsible for the day-to-day operational tasks related to Medicare Part D processes, including Prescription Drug Event and Medicare Plan Finder. Effectively manage day to day tasks processes assuring adherence to client and Centers for Medicare and Medicaid requirements. Direct and manage activities and resources to support client and internal requests, adjust plan as needed. Provide timely second-tier triage support to the Medicare Part D Analysts and act as a subject matter expert for other areas to verify and analyze operational situations and/or issues referred for validation. Support urgent processing issues including doing research, analysis, identification of root cause, impact analysis determination and corrective action. Define operational and project tasks and resource requirements. Assist team during the development and testing of operational and project deliverables. Monitor operation, project deliverables and schedule timelines. Establish effective communication between all stakeholders. Identify and resolve escalating issues and conflicts within the operation, project execution, or implementation. Develop best practices and tools for operation, project execution, and management.

What you’re made of

The bold requirements…

Bachelor degree in Healthcare, Business, or related field. (In lieu of a degree, equivalent, relevant work experience may be considered.) 3+ years of Medicare Part D operational experience within a health plan or pharmacy benefit manager (PBM). 3+ years of experience managing and guiding a team towards daily, weekly, and monthly goals. Experience as a leader with a proven track record of leadership experience. Highly organized thinker, speaker, and planner with the ability to coach others in these areas. Able to utilize programming and dashboard tools, e.g. Tableau, QlikView, Excel tools, SQL. Ability to oversee and motivate a team; excellent communication skills, and a customer service focus. Excellent oral and written communication skills.

That something extra we´d love to see…

Detailed Attention to Detail Problem Solver Leader/Mentor

Physical requirements…

Must be able to access and navigate each department at the organization’s facilities. Sedentary work that primarily involves sitting/standing.

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