Clinical Coordinator Manager at SlateRx

Las Vegas, Nevada, United States -

Full Time

Start Date

Immediate

Expiry Date

13 Sep, 26

Salary

100000.0

Posted On

15 Jun, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Staff Management, Pharmacy Benefit Management, Clinical Operations, Coverage Determinations, Appeals Process, Performance Evaluation, Mentoring, Cross-functional Collaboration, Communication Skills, Time Management, Organization, Regulatory Compliance

Industry

Hospitals and Health Care

Description

Company Bio: Founded by industry pioneers, SlateRx provides simple and affordable pharmacy benefit programs to employer groups, unions, public sector groups, health systems, and other payers throughout the United States. As the industry’s only PBXTM, SlateRx is creating real value for plan sponsors on day one through purchasing scale and continued management via innovation and transparency. Our model is designed to improve an out-of-touch healthcare model to make pharmacy benefits simple and affordable for plan sponsors and members. Job Overview: The Clinical Coordinator Manager is responsible for leading a team of Clinical Coordinators who support the coverage determinations and appeals processes of SlateRx, LLC. This position will be responsible for the day-to-day activities of clinical operations, including efficiency, accuracy and timeliness of reviews. Responsibilities: As a Clinical Coordinator Manager, your key responsibilities will include: * Lead the Clinical Coordinator team, inclusive of hiring, coaching, and evaluating staff. * Support and advise Clinical Coordinator Supervisors with member, client, and software issues. * Handle escalated clinical issues, including escalated calls. * Oversee the research claim reject messaging associated with coverage determination and appeal requests. * Ensure response to routine inquiries and correspondence regarding coverage determinations and appeals with members, prescribers, and pharmacies is handled completely and appropriately as applicable. * Ensure the coverage determination and appeals process from start to finish is being handled efficiently and requests are completed timely. * Monitor and update Clinical Coordinator productivity reports. * Oversee the Clinical Coordinator monthly schedules to ensure appropriate coverage for timely completion of coverage determinations and appeals, and answering of calls. * Report accomplishments, infractions, and overall productivity to upper management. * Oversee staff training on changing procedures and PA automation system. * Conduct performance evaluations. * Promote and foster a professional, positive, dynamic team environment through exemplary leadership. * Mentor staff to improve skillset and career development. * Advise on employee promotions, transfers and dismissals. * Collaborate with cross-functional team leads to streamline and drive efficiencies in the coverage determination process. * Perform miscellaneous job-related duties as assigned. Qualifications: To excel in this role, you should possess the following qualifications: * Knowledge of pharmacy benefit management, CDAG operational processes, and regulatory requirements. * Computer and typing proficiency. * Ability to adapt to a dynamic and fast-paced environment. * Staff management experience. * Possess excellent communication skills. * A good educator who is trustworthy and willing to share information and serve as a mentor. * Demonstrated ability to manage multiple priorities and deadlines. * A well-organized and self-directed individual who is able to work with minimal amount of supervision. * Capability to efficiently complete tasks in a demanding environment. Education: High school diploma or GED required; Bachelor’s degree strongly preferred. License Requirement: Current and valid Pharmacy Technician Certification, Licensure, or Registration; OR a minimum of 8 years’ experience with appropriate industry experience, preferably in the healthcare, insurance or PBM industry. Job Benefits: Health, Dental, Vision, Life, 401k, Paid Time Off. Location: Remote

Responsibilities

Lead a team of Clinical Coordinators to manage coverage determinations and appeals processes efficiently. Oversee day-to-day clinical operations, including staff hiring, coaching, and productivity reporting.