Regional Team Lead - Prior Authorizations - Certified Specialty Pharmacy Te at Shields Health Solutions

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Full Time

Start Date

Immediate

Expiry Date

22 Jun, 26

Salary

0.0

Posted On

24 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Leadership, Patient Advocacy, Benefit Investigations, Prior Authorizations, Financial Assistance Programs, Insurance Rejections, Claim Issues, Documentation, Team Monitoring, Mentorship, Workflow Best Practices, System Navigation, Auditing, Quality Standards, KPI Monitoring, Process Improvement

Industry

Hospitals and Health Care

Description

Job Purpose: This role blends leadership and patient advocacy responsibilities, supporting the supervisor in ensuring the team has the tools and guidance needed to succeed while maintaining direct patient care responsibilities. Job Duties: Patient Advocacy & Clinical Support Maintain direct patient support responsibilities including benefit investigations, prior authorizations and financial assistance programs. Troubleshoot insurance rejections and claim issues. Communicate professionally with patients, clinicians, and payors. Demonstrate clear and concise documentation practices to ensure accurate, timely, and compliant record-keeping across patient interactions and workflow processes. Team Leadership & Support Assist the supervisor in monitoring daily team activities and work queues. Provide mentorship and stabilization support for new hires. Share and educate team members on workflow best practices and system navigation. Support clinic growth and stabilization efforts across therapeutic areas. Provide coverage for clinics with staffing gaps or PTO needs. Manage overflow work needs of supported clinics Lead by example, fostering a collaborative and positive team culture Build strong relationships with internal teams, clinic partners, and cross-functional teams. Actively participate in team meetings, training sessions, and knowledge-sharing forums. Operational Excellence Perform audits to ensure workflow adherence and quality standards. Contribute to special projects and process improvement initiatives. Report feedback and insights to supervisors to optimize team performance. Monitor Key Performance Indicators (KPIs), assess gaps in meeting site and organizational goals, and develop targeted action plans to drive continuous improvement. A core responsibility of this role is to ensure the team consistently achieves performance metrics that reflect broader organizational objectives, with a focus on collective outcomes rather than individual contributions. Experience/ Education: Nationally certified Pharmacy Technician (CPhT via PTCB or ExCPT). Registered or willing to register with the state of employment. 2+ years of experience in specialty pharmacy, patient engagement, or prior authorization. Internal candidates: Minimum 6 months in the Patient Support Center. Proven track record of exceeding performance expectations and service levels. California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy. By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment. Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Responsibilities

This role involves blending leadership duties, such as monitoring team activities and providing mentorship, with direct patient advocacy, including handling benefit investigations and prior authorizations. A core focus is ensuring the team consistently meets performance metrics reflecting broader organizational objectives.