Pharmacy Call Center Lead - Remote Mississippi - Any city, MS, US, 99999

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

The Pharmacy Call Center Lead is expected to be a subject matter expert in areas of pharmacy knowledge as well as call center operations. Duties will include, but are not limited to, appropriate processing of prior authorization requests, research and resolution of escalations received at the member, provider, or pharmacy level, initial and continued training of the pharmacy technician team, ongoing quality review of the technician team to identify areas of additional coaching or improvement and working with other supervisors and managers as needed to assist in oversight and productivity of the team.

Your role in our mission

• HIPAA Compliance Champion: Ensure adherence to all Protected Health Information (PHI) protocols and regulations to safeguard patient privacy.
• Prior Authorization Efficiency Expert: Process submitted prior authorization requests efficiently within established timeframes, completing approvals that meet defined criteria without requiring pharmacist intervention.
• Communication Ace: Provide clear and consistent communication to both members and providers regarding the status of prior authorizations and address any inquiries effectively.
• Problem-Solving Superhero: Utilize knowledge and resources to resolve incoming calls on initial contact, following established standard operating procedures.
• Customer Care Champion: Deliver exceptional customer service, fostering positive interactions with members …