PBM Call Center Manager

🔥 0 minutes ago

🏈 Alabama – Remote

🏈 Alabama – Remote

💵 $87.3k - $124.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📞 Call Center Representative

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

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

• Lead day-to-day PBM call center operations • Ensure service levels, productivity, quality, and customer experience goals are achieved • Lead, coach, and develop supervisors and customer service teams • Monitor and analyze SLAs, KPIs, quality metrics, customer satisfaction, and operational trends • Ensure compliance with Medicaid, HIPAA, PBM, contractual, and regulatory requirements • Oversee workforce planning, staffing, scheduling, training, and operational readiness • Partner with clients, pharmacies, providers, state stakeholders, and internal teams to resolve escalations • Address service issues and implement process improvements • Use operational data and performance metrics to identify trends, address service gaps, and drive continuous improvement • Collaborate with a geographically dispersed healthcare operations team and healthcare stakeholders

🎯 Requirements

• Three (3) or more years of experience in healthcare, Medicaid, PBM, pharmacy, or related healthcare operations • Demonstrated leadership experience managing teams within a high-volume call center or contact center environment • Strong knowledge of call center operations, including SLAs, KPIs, quality management, workforce planning, performance management, and customer experience • Knowledge of NCPDP standards • Knowledge of healthcare regulatory and compliance requirements • Strong analytical, communication, problem-solving, and leadership skills • Ability to analyze data and translate findings into operational improvements • Medicaid/PBM experience strongly preferred • Five (5) or more years of call center leadership experience preferred • Experience with pharmacy claims, prior authorization, Lean Six Sigma, project management, and/or Pharmacy Technician certification is a plus

🏖️ Benefits

• Comprehensive medical, dental, and vision coverage • 401(k) retirement savings plan • 401(k) employer match • Employee wellness benefits • Financial benefits • Professional development opportunities • Career growth opportunities • Educational assistance • Flexible vacation policy • Leadership and technical development academies • Work flexibility • Learning and career development