Wayne, New Jersey
San Antonio, Texas
Buffalo, West Virginia
Cincinnati, Ohio
Posted: 07-Jan-23
Location: Sanford, Florida
Salary: Open
Categories:
Internal Number: 22043307
Description
All the benefits and perks you need for you and your family:
- Benefits from Day One
- Paid Days Off from Day One
- Career Development
- Whole Person Wellbeing Resources
- Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Full Time
Shift: Monday – Friday
Location: 582 Monroe Rd Suite 1412 Sanford, FL 32771
The role you’ll contribute:
The Pharmacy Processing Manager is responsible for all activities regarding Rx Plus Pharmacy’s state licensed data entry, claims adjudication, prior authorization, pharmacy specialist, and technician quality assurance staff and processes. This position coordinates the day-to-day activities of prescription order intake of various media, technician quality assurance, claims adjudication and copay assistance, prior authorization, and prescription clarification processes to ensure timely completion in accordance with the pharmacy’s stated goals. Is a member of AdventHealth’s employee health plan prescription benefit administration team and is a subject matter expert in State and Federal pharmacy laws and regulations. The Pharmacy Processing Manager hires, trains and manages team members and supervisors of the processing intake, prior authorization, specialist, and quality teams and is required to understand all pharmacy processes excluding Pharmacist’s duties. This position resolves difficult issues regarding new and refill prescription orders, prescription turnaround times and other matters that require sensitivity and speed.
The value you’ll bring to the team:
- Collaborate with facility Director(s) and Sr. Manager(s) to achieve stated goals and accountabilities for processing team staff daily and throughout the year.
- Develop and report individual and departmental metrics and accountabilities on a monthly basis and as requested, including pharmacy technician accuracy, productivity, and prescription processing turnaround.
- Responsible for in depth understanding of pharmacy’s services; articulates to staff to assure goals are met with increased safety and efficiency.
- Plays an active role on the AdventHealth employee health plan prescription administration team, offering support and education regarding pharmacy benefits and management, prior authorization and eligibility issues for all covered employees and dependents across the enterprise.
- Lead staff to execute processes and procedures effectively, providing leadership and guidance on prescription plan questions, new and refill order entry and adjudication, pharmacy processes and additional training as necessary.
- Responsible for introductory and annual evaluations of all new hires/transfers into the processing and quality technician positions, including supervisors, promoting employee growth and development. Determine daily goals and specific duty assignments for processing team staff and monitor prescription workflow queues for appropriate and timely follow through.
- Conduct extensive interviews for new hire recruitment ensuring the right person is hired based on qualifications and skillset as they would fit best within the organization.
- Maintain solid vendor and customer relationships by conducting business interactions with speed, knowledge, and professionalism. Acts as a resource to AdventHealth retail pharmacy locations, providing guidance on prescription plan questions and claims adjudication troubleshooting.
- Responsible for the integrity of patient sensitive material included in prescription orders, ensuring no violation of patient protected health information (PHI) or payment card industry data (PCI). Works with Corporate Responsibility to ensure that staff receive ongoing training and certification of CORE requirements
- Monitors the results of delegations, assignments, or projects, considers the skills, knowledge, and experience of the assigned individual and the characteristics of the assignment or project.
- Develop and leverage relationships within and across work groups to achieve results.
- Supports corporate compliance by reporting and following up with medication errors and privacy events and serves as an active participant on the Continuous Quality Improvement (CQI) committee.
- Works with Clinical and Operational leaders to develop and maintain registered pharmacy technician competencies for department staff, scheduling training and in services as needed. Tests staff on competencies annually or as part of performance improvement activities.
- Works with other operational leaders to ensure processing staff speaking with customers remain up to date on customer service guidelines, supports pharmacy’s call center and member services departments as needed to ensure a positive patient experience.
- Responsible for in depth understanding of the Prescription Drug Monitoring Program (PDMP) works with Clinical leaders to ensure control substance reporting requirements are upheld in all 50 states, providing education to pharmacy technician and support staff as needed.
- Other duties as assigned.
The expertise and experiences you’ll need to succeed:
- Bachelor’s degree in Healthcare Management, Business, Informatics, or related field required.
- 4+ years’ experience as a pharmacy technician in retail, specialty, central fill, or mail-order pharmacy.
- One year of leadership experience
- A current Florida Board of Pharmacy Technician Registration, RPT; must complete state required continuing education requirement for registration.
- National Pharmacy Technician Certification, CPhT; must complete national required continuing education requirement for certification.