Pharmacy Benefit Verification Supervisor

Overview Location: Houston, TX Job Id: 5167 # of Openings: 1 Role: Pharmacy Benefit Verification Supervisor. This is a full-time position in our expanding Specialty Pharmacy program. Work hours: Monday to Friday, 10:30am to 7:00pm CST. Must be within commuting distance to our Houston pharmacy location; remote work available after initial training period. Salary: Starting at $63k and up, depending on experience. We offer a variety of benefits including: 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Quarterly Incentive Bonus Company paid benefits – life insurance; and short and long-term disability Responsibilities The Pharmacy Benefit Verification Supervisor is responsible for oversight of activities relating to the proper loading and investigation of patient prescription benefits, including patient demographics, medical and pharmacy coverage, and investigation/identification of authorization requirements needed to obtain medication coverage. This role provides quality control by regularly examining cases completed by team members. Supervise BV/onboarding staff in a leadership role to maintain a positive working environment, foster teamwork, minimize employee relations issues, and reduce turnover. Communicate effectively across pharmacy and/or corporate teams and with patients; resolve issues. Assist manager in day-to-day pharmacy operations and in implementing new procedures to ensure accurate and timely dispensing of quality pharmacy services. Recruit, hire, orient, develop, and train new associates; evaluate, coach, and apply performance management practices; deliver corrective action plans as needed. Manage daily activity of BV team members, including workflow monitoring and Pulse reporting. Manage patient authorizations (e.g., TOA, LOA) and related processes. Monitor and escalate No-Go trends or contract-related claim rejections to the Patient Benefits Manager. Provide ongoing access and training on web tools to BV/Onboarding and offer frontline support for system functionality questions (provider eligibility portals, copay card portals, applications, etc.). Communicate payer benefit programs and policies to Pharmacy personnel and ensure correct handling of all payer types by the team. Handle escalations for difficult BV cases to ensure accurate and timely completion of BV. Collaborate with the Pharmacy Technician Manager and/or Director of Pharmacy Operations on other responsibilities, projects, implementations, and initiatives as needed. Maintain a safe and clean pharmacy by complying with procedures, rules, regulations, and patient confidentiality laws; contribute to team efforts and perform related tasks as assigned. Education / Learning Experience Required: High School Diploma or GED. Prior experience in Pharmacy, Medical Billing, or Benefits Verification Desired: Associate or Bachelor’s Degree, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience Work Experience Required: 4+ years of pharmacy or benefits verification experience, prior leadership experience Desired: 5+ years of pharmacy or benefits verification experience, 1+ year supervisor experience, Specialty pharmacy experience Skills / Knowledge Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge of Medicare, Medicaid, and commercial insurance; pharmacy test claim and NCPDP claim rejection resolution; coordination of benefits; NDC medication billing; excellent interpersonal skills; ability to work with all levels of management and staff; strong knowledge of pharmacy terminology and processes (sig codes, Roman numerals, brand/generic names); strong typing, math, analytical, and leadership skills Desired: Specialty pharmacy operations, independent decision-making abilities, ability to conduct research, resourceful and self-reliant, excellent communication skills Licenses / Certifications Required: Registration with Board of Pharmacy as required by state law Desired: Certified Pharmacy Technician (PTCB), Advanced Certified Pharmacy Technician with Billing and Reimbursement certification Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, meet deadlines, be flexible, detail-oriented, strong time-management, leadership Why Onco360? Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. A career with us is more than just a job. It’s an opportunity to connect and care for our patients, providers, communities and each other. We value teamwork, respect, integrity, and passion. We succeed when you do, and our company and management team work hard to foster an environment that provides opportunities for professional and personal growth. #J-18808-Ljbffr