Address
Form of workPerform functions to plan for, manage, and provide clinical oversight of the Patient Access function, involving initial intake, insurance benefits investigation, and authorization requirements, cultivating an environment of outstanding customer service, as the voice of the company in all interactions with referral sources and patients. Demonstrate the company s core values of respect, honesty, integrity, diversity, inclusion, and safety.From one tiny Cincinnati grocery store more than a century ago, we've grown into what today is the nation's largest grocer with nearly 2,800 stores in 35 states operating under 28 different names. As America's grocer, we take pride in bringing diverse teams with a passion for food and people together with one common purpose: To Feed the Human Spirit. With a history of innovation, we work tirelessly to create amazing experiences for our customers, communities AND each other, with food at the heart of it all.
Here, people matter. That's why we strive to provide the ingredients you need to create your own recipe for success at work and in life. We help feed your future by providing the value and care you need to grow. If you're caring, purpose-driven and hungry to learn, your potential is unlimited.
Whether you're seeking a part-time position or a new career path, we've got a fresh opportunity for you. Apply today to become part of our Kroger family! Minimum
- Doctorate Degree Pharmacology
- 3+ years leadership experience
- Knowledge of current medical services technology applications
- Strong people and systems management skills
- Strong knowledge of business and ability to analyze data to identify actions to be taken
- Proven ability to identify and implement superior customer service model
- Ability to identify training requirements and develop and implement training model focused to improve results
- Keen understanding of technology as productivity and efficiency enhancement tools.
- Bilingual in Spanish/English may be required in certain jurisdictions
- Knowledge of medical benefits and insurance standards, investigation processes, and compliance requirements for reimbursement
Desired
- Any specialty pharmacy experience- Manage the Patient Access team in the processing of new patient referrals, insurance benefit investigation and verifications, and procurement of authorizations based on clinical criteria provided by prescriber
- Train and provide clinical refreshers to the Patient Access team regarding drug therapy, treatment management, and disease states as new indications enter the market
- Participate in drug launches, quarterly business reviews, and enhanced quality calls with our external partners
- Resolve clinical escalations presented by either the prescriber, payer, patient, or external partner
- Maintain the clinical integrity of the prior authorization, appeal, and denial process and procedures
- Establish, communicate, and maintain operating policies, processes and procedure covering functional area, to improve efficiency, quality and compliance, and related performance expectations
- Monitor results to evaluate compliance with quality and productivity expectations and identify opportunities for improving results
- Establish customer service standards of excellence and ensure compliance
- Balance workload and manage schedules of associates to suit demand and service standards
- Interview, select, recommend hire, train and assign department associates; develop and communicate performance metrics to assess the effectiveness of associates
- Supervise and coach direct reports in the performance of their duties; complete performance reviews and provide feedback to direct reports
- Perform or assist with any operations, as required to maintain workflow and to meet business needs
- Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies
- Perform other related duties as assigned
- Must be able to perform the essential job functions of this position with or without reasonable accommodation
