Orlando FL 32812
Job DescriptionThis position provides administrative oversight and management of a site or line of business Prior Authorization (PA)/Utilization Management (UM) department responsible for managing the delivery of member and provider services. This position plays a key role in initiatives critical to Magellan in achieving revenue goals and operational objectives. The position requires communication and teamwork across internal departments (account management, implementations, IT, quality, specialty pharmacy), in order to achieve objectives and SLAs. This position is also accountable for hiring, developing, mentoring, training and retaining staff.
- Manages the pre-authorization process and customer service requirements to ensure compliance, quality and customer service level agreements are met.
- Manages and coordinates the activities of the team to efficiently manage the output of assigned tasks.
- Monitors the performance of team members by means of reports and observation.
- Assumes accountability for team conduct and productivity.
- Monitors individual team member’s attendance and reliability patterns.
- Administers performance improvement or corrective action plans when needed.
- Coaches, mentors and develops Team Leaders/Supervisors and staff with a focus on quality and accuracy of service.
- Works across divisional lines to ensure staff is properly trained and issues needing resolution are addressed timely.
- Creates a culture of support, accountability and continuous improvement.
- In collaboration with the Training Department, plans and develops training programs for department staff.
- As the end user and system expert, proactively suggests changes/updates to the prior authorization application that ensures maximum protocol adherence, documented medication savings, and increased health plan customer satisfaction.
- Possesses financial responsibility for meeting administrative budgets and the creation of innovative efficiencies.
- Assists divisional management with the implementation of improvement initiatives and new business implementations.
- Partners with Account Management and business clients to improve communications and address issues that may arise.
- For Managers assigned to Clinical Programs: Assists in completing calls for clinical, specialty clinical, account management and all other programs carried out by the clinical department. Assists in building out/organizing program protocol. Ensure all organizational documents are generated and cataloged according to internal protocols.
General Job Information
Job FamilyPharmacy Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date12/17/2019
Date Requisition Created12/17/2019
Work ExperienceCustomer Service, Pharmacy, Supervisory
License and Certifications - Required
License and Certifications - PreferredCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
Other Job Requirements
- Excellent written and verbal communication skills.
- Working knowledge of Microsoft Office Product Suite.
- Comfortable and willing to learn new technology and software applications.
- Strong problem solving skills.
- 3+ years' direct supervisory experience.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
Top 5 reasons to work at Magellan
Meaningful Work With People Who Care
At Magellan Health you can do meaningful work and feel confident that you matter in an organization that makes a real difference in the world - one that cares deeply and uses its employees’ collective insight as a competitive advantage.Read More
We are Compassionately Curious
Magellan Health is a place where we listen with real empathy. It’s one of our biggest strengths. It helps us to support each other and develop innovative solutions for the fastest growing, most complex areas of healthcare.Read More
We are Better Together
We rely on our innate ability to work as a high-functioning collaborative team to facilitate compassionate care to all of our members. With such interdependency comes trust, challenge and innovation.Read More
We believe work and life should flow together in unison. We offer resources that match your professional development, a culture that welcomes your ideas, and unparalleled flexibility to fit work around your life.Read More
Be your best at Magellan Health. We’re a collective of remarkably motivated and driven professionals. As a team, we’re proud of the high standards we set for each other and we’re continually inspired to do our best work.Read More
When you sayLife @ Magellan
To be the best you have to work with the bestWe hear you