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Manager, Patient Access - Bilingual (ENG/SPA) & PR Pharmacist license REQUIRED

Company Name: Kroger Specialty Pharmacy
Position Type: Employee
FLSA Status: N/A



Position Summary

Perform functions to plan for and manage the Patient Access function, involving initial intake, insurance benefits investigation, and authorization requirements, cultivating an environment of outstanding customer service, as the voice of the company in all interactions with referral sources and patients. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.

Essential Job Functions

  • Manage the Patient Access team in the processing of new patient referrals, insurance benefit investigation and verifications, and procurement of authorizations
  • Establish, communicate, and maintain operating policies, processes and procedure covering functional area, to improve efficiency, quality and compliance, and related performance expectations
  • Monitor results to evaluate compliance with quality and productivity expectations and identify opportunities for improving results
  • Identify and guide the implementation of new or upgraded technology to enhance team performance
  • Establish customer service standards of excellence and ensure compliance
  • Monitor and work with associates to provide training and improve skills involved in patient coverage investigation, patient application evaluations, compliance with service standards, evaluation and maximization of reimbursement in relation to costs, efficiency, and service
  • Balance workload and manage schedules of associates to suit demand and service standards
  • Interview, select, recommend hire, train and assign department associates; develop and communicate performance metrics to assess the effectiveness of associates
  • Evaluate performance and provide counseling, cross training and coaching to associates; develop and implement staffing plans and related budgets as required
  • Communicate with external sales force to receive and provide information regarding individual account requirements and expectation and resolve customer/patient issues
  • Supervise and coach direct reports in the performance of their duties; complete performance reviews and provide feedback to direct reports
  • Perform or assist with any operations, as required to maintain workflow and to meet business needs
  • Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies
  • Perform other related duties as assigned
  • Must be able to perform the essential job functions of this position with or without reasonable accommodation
  • Minimum Position Qualifications

  • High School Diploma or GED
  • 4+ years of experience as a supervisor or above
  • 4+ years of call center/customer care management experience
  • Knowledge of current medical services technology applications
  • Knowledge of medical benefits and insurance standards, investigation processes, and compliance requirements for reimbursement
  • Doctorate in Pharmacology and Pharmacist certification/licensure may be required in certain jurisdictions
  • Bilingual in Spanish/English may be required in certain jurisdictions
  • Keen understanding of technology as productivity and efficiency enhancement tools.
  • Able to identify training requirements and develop and implement training model focused to improve results
  • Proven ability to identify and implement superior customer service model
  • Strong knowledge of business and ability to analyze data to identify actions to be taken
  • Strong people and systems management skills
  • Desired Previous Experience/Education

  • Any healthcare or specialty pharmacy experience
  • Bachelor's Degree in Business, Marketing or similar discipline

    Education Level: High School Diploma/ GED Required
    Required Certifications/Licenses: Pharmacy Board License
    Position Type: Full-Time 
    Shift(s): [[mfield4]]

    Regions: Any


    Jobs at Kroger: At Kroger, we hire people who have a passion for helping others and who want to build a relationship with our Customers. No matter what stage of your career, you can build your future at Kroger. We look for people who want more, aspire to be more and work hard to achieve their goals. Our focus on keeping the Customer first is what makes us successful. We offer many opportunities not only in our stores, but in Manufacturing, Logistics, Marketing, Finance, Human Resources, and many other fields.

    Company Overview: Kroger Family of Companies employs nearly half a million associates who serve over 11 million customers daily through a seamless shopping experience under a variety of banner names.  At The Kroger Co., we are Fresh for Everyone™ and dedicated to our Purpose: To Feed the Human Spirit®.  We are committed to creating #ZeroHungerZeroWaste communities by 2025.  Careers with The Kroger Co. and our family of companies offer competitive wages, flexible schedules, benefits and room for advancement.


     Posting Notes:  PR || San Juan || 1001 San Roberto Street || 00926 || Kroger Specialty Pharmacy || None || Call Center; Pharmacy; Specialty Pharmacy || Employee || Exempt || Full-Time || Pharmacy Board License 

    Nearest Major Market: Puerto Rico
    Nearest Secondary Market: San Juan

    Job Segment: Medical, Pharmacy, Developer, Marketing Manager, Healthcare, Bilingual, Technology, Marketing

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