Supervisor, Rx Customer Service

Summary

Join Abarca's revolution in healthcare as a Supervisor for Rx Customer Service, leading a team in supporting beneficiaries, clients, physicians, and pharmacies. You will oversee scheduling, training, performance metrics, and quality monitoring, while assisting specialists with communications and issue resolution using Abarca's proprietary platforms. Responsibilities include preparing team schedules, monitoring performance, coordinating training, managing incoming communications, and monitoring call center metrics. The role requires an Associate's Degree as a Pharmacy Technician (or equivalent experience), 6+ years of relevant experience, supervisory experience, and excellent communication skills. A flexible hybrid work model is offered, with potential for on-call hours.

Requirements

• Associate’s Degree as Pharmacy Technician. (In lieu of a degree, equivalent relevant work experience may be considered)
• 6+ years of experience working in pharmacy or healthcare call center areas
• Experience as a Supervisor or leading teams
• Experience within lines of business in pharmacy benefit management, clinical operations and/or Medicare Part D
• Excellent oral and written communication skills
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable)
• Must be able to access and navigate each department at the organization’s facilities
• Sedentary work that primarily involves sitting/standing

Responsibilities

• Prepare monthly team schedules while taking into consideration call volumes, peak hours, personnel availability, and seasonal events
• Monitor Rx Customer teams’ timeliness and attendance, ensuring specialists are complying with their scheduled hours and that all information entered within payroll systems (UKG and ADP) is accurate
• Monitor incoming calls and back-office duties for purposes related to quality, compliance, and employee development
• Coordinate training and development courses on both a team and one-on-one basis as needed
• Assist Rx Customer Service Specialists in managing all incoming calls, emails, faxes, and web-generated requests from pharmacies, beneficiaries and prescribers including but not limited to coverage determination, exception and appeal status and rejection support including overrides
• Real-time, daily, and monthly monitoring of call center performance metrics to ensure proper adjustments are made in a timely manner and that all calls are managed within the service-level standards set by Center for Medicare and Medicaid Services (CMS) and our clients
• Document administrative prior authorization (PA) request inquiries, issues, status, and resolution in accordance with federal and department / company policies and guidelines
• Answers questions and recommends corrective actions to address customer complaints, payment status, manual reversal requests, benefit/eligibility support, provider portal support and responses to price appeals
• Responsible for mentoring, development of team, performance review, growth conversation, and calibration processes
• Support the Knowledge Accelerator team in creating content, as needed, for training on subject matter expertise and process

Preferred Qualifications

• Current and Active Certified Pharmacy Technician License
• Experience in insurance, pharmacy, and / or healthcare preferred
• Experience within pharmacy benefit management (PBM) clinical operations and Medicare Part D

Benefits

We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)