Healthcare Team Manager
2 days ago
Sparks Group is seeking an experienced Team Lead to manage a team of Medical Reimbursement Analysts for a 5-month contract. The ideal candidate will have 2+ years of direct industry experience, excellent coaching and team-building skills, and the ability to work in a fast-paced environment.
Key Responsibilities:- Cultivate strong relationships with internal and external stakeholders, including providers, payers, PBMs, sales representatives, and senior-level client contacts.
- Conduct in-depth research and analysis of moderate to complex reimbursement policies and procedures.
- Review and manage patient cases, interacting with patients, healthcare providers, payers, and pharmaceutical/biotech sales teams.
- Assess patient insurance coverage prior to prescription triage, ensuring optimal pharmacy options for client-specific products.
- Accurately document all program activities in the CRM database, adhering to strict timelines and utilizing standardized templates.
- Monitor and update payer prior authorization requirements and coverage policies for specified client programs.
- Prepare and/or assist with the preparation of specific reports.
- Review and process documentation to determine patient eligibility for client patient assistance programs.
- Coach and develop case managers and intake coordinators, conducting quality monitoring and assurance activities.
- Attend client meetings, off-site training, and conferences, with an estimated travel time of 10%.
- Bachelor's degree or equivalent work experience in healthcare.
- At least four years of recent healthcare experience, with a minimum of two years in direct patient care preferred.
- Advanced knowledge of medical insurance (both public and private), billing and coding, and related healthcare terminology.
- Proven experience as a senior case reimbursement analyst with at least 3-5 years of hub experience.
- Proficient in Microsoft Office Suite.
- Demonstrated excellence in customer service, preferably with call center experience.
- In-depth knowledge of payer and PBM processes to guide team members in improving patient access.
- Strong problem-solving, research, and analytical abilities.
- Excellent written and verbal communication skills.
- Proven ability to multitask and manage time effectively.
- Preferred experience interacting with clients.
Sparks Group is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, pregnancy, citizenship, family status, genetic information, disability, or protect veteran status.
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