Elk Grove, IL, United States
Required Knowledge, Skills, & Training:- Previous leadership/management experience.- Experience with Major Medical Insurance.- Knowledge of pharmacy benefits.- Knowledge of HCPCs codes.- Able to multitask.- Able to work well in a fast-paced working environment. Essential Job Duties:- Monitors the production and quality of the work produced by the team using a variety of reports and audit tools. Makes adjustments to assignments daily to achieve maximum results. Ensures account audits are completed weekly.- Establishes individual employee goals and provides timely performance feedback. Recognizes and rewards good performance. Addresses and resolves Human Resource issues following policies and procedures including disciplinary action. Escalates issues to HR appropriately. Completes yearly performance reviews.- Conducts interviews, hires, trains, and motivates team. Interfaces with contingent workforce company managers. Makes certain employees have all needed tools including appropriate system access. Approves time for permanent and contingent workforce.- Responsible for integration of new Specialty business for therapies handled by assigned team. Disseminates accurate information to the team.- Functions as the main resource for questions regarding admissions policies and procedures. Resolves escalated Specialty Benefits Verification issues. Collects and publishes data, establishes facts, draw conclusions, solves problems, and responds to inquiries. Ensures that other departments are involved when needed. Escalates IT problems appropriately.- Responsible for helping to develop policies and procedures and process improvement strategies within the department. Communicates procedure changes to departments affected by that change.