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Express Scripts Supervisor, Eligibility - Accredo in Memphis, Tennessee

POSITION SUMMARY

The Supervisor – Eligibility manages a team of Eligibility Associates responsible for coordinating, tracking and maintaining patient eligibility for a program using established guidelines and procedures in response to patient and physician calls. This position may also oversee billing and collections operations and/or activities related to obtaining health insurance benefits or other financial assistance for patients. This position continuously monitors and identifies areas in which day-to-day operational efficiencies can be increased, re-work can be decreased and overall production of the department falls within established productivity and quality standards.

ESSENTIAL FUNCTIONS

  • Assists with the development of short & long-term goals for department and plan of implementation to bring to completion for on-going success of department.
  • Ensures the success of maintaining strong working relations with clients and prompt communication regarding concerns or problem resolution occurs.
  • Direct assigned team members in accordance with departmental management initiatives.
  • Schedule & facilitate routine staff meetings to communicate department/company processes and/or changes.
  • Follow up with assigned coordinators to ensure policies and procedures are understood and compliant.
  • Provides department leadership in the area of staff performance including mentoring, auditing, productivity monitoring and coaching for success.
  • Corresponds with management on employee/HR issues, state of the department and any service issues involving key clients or legal risk issues to the company.
  • Analyze reporting data trends within team relative to quality to ensure efficiency and productivity requirements are maximized to benefit patients.
  • Provide feedback to team related to productivity and efficiency.
  • Assist team members to resolve patient concerns and handling escalated issues relative to prior authorizations,benefits/eligibility,etc.
  • Monitor quality and case volume through the generation of client database and Call Center reports, random call monitoring and random case file audits.

QUALIFICATIONS

  • Bachelor’s degree in related field or 6 to 8 years of experience.
  • 0-2 years relevant experience with Bachelor’s Degree.
  • Previous leadership experience preferred.
  • Strong knowledge of Word, Excel & Power Point preferred.
  • Must possess excellent oral and written communication skills.
  • Ability to coordinate/host meetings with large groups.
  • Ability to interpret data/metrics within the database system and staffing tools and interpret data for application.

ABOUT THE DEPARTMENT

Through our range of health care products and services offered, Accredo team members provide in-depth care for patients with chronic health conditions like hemophilia, oncology, rheumatoid arthritis and growth hormone deficiency. In addition to health care products, we provide comprehensive management services – including outcomes measurement, counseling, clinical care management programs, social services and reimbursement services. By performing in these very high-touch roles, employees have a daily opportunity to make a positive impact on their patients’ lives.

ABOUT EXPRESS SCRIPTS

At Express Scripts, we dare to imagine a better health care system, and we’re driven to make it happen. Where some see obstacles, we see possibilities. We’re challengers, difference-makers and opportunity-seekers, united with our partners in pursuit of a simpler, more sustainable system and better health for all.

We have always acted first to take on the toughest challenges. We uniquely partner across the health care ecosystem to uncover opportunities, take action, advance health care and deliver better outcomes – like no one else can. We believe health care can do more. We are Champions For BetterSM.

Express Scripts, part of Cigna Corporation, unlocks new value in pharmacy, medical and beyond to further total health for all.

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