Customer Support Manager

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🤠 Texas – Remote

🤠 Texas – Remote

💵 $75.7k - $108.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💝 Customer Support

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Leads customer support operations for Prior Authorization (PA) services within the state PBM (sPBM) program • Ensures high-quality service delivery, regulatory compliance, and efficient processing of pharmacy benefit requests • Lead and develop customer support teams managing prior authorization workflows and member/provider inquiries • Drive performance across key operational metrics (service levels, quality, turnaround times, productivity) • Oversee escalations and ensure timely resolution of complex PA and pharmacy-related issues • Ensure compliance with state Medicaid requirements, clinical guidelines, and PBM regulations • Partner with clinical, operations, and state stakeholders to improve processes and service delivery

🎯 Requirements

• High school diploma or equivalent required • 5+ years of PBM, healthcare call center, or prior authorization experience • 2+ years of leadership or team management experience • Strong knowledge of prior authorization processes, pharmacy benefits, and Medicaid programs • Experience managing KPIs, reporting, and operational performance

🏖️ Benefits

• flexible vacation policy • 401(k) employer match • comprehensive health benefits • educational assistance • leadership and technical development academies to help build your skills