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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing program operations, including budget adherence, team supervision, and development of program metrics. Proficient in pharmacy benefit management and customer service, with strong analytical and communication skills.
Highest-signal resume keywords
Pharmacy Benefit ManagementMedical Benefit VerificationsPrior AuthorizationTeam LeadershipMicrosoft Office
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Program Operations ManagementBudget ManagementOperational ImprovementTraining DevelopmentQuality Compliance Tracking
Soft Skills
Verbal CommunicationWritten CommunicationAnalytical Problem-SolvingTeam CoordinationCustomer Service
Industry Keywords
Specialty PharmacyPatient Support ServicesCall Center ExperienceService-Level AgreementsWorkflow Processes
About the role
Key responsibilities & impact- Manage day-to-day activities of program operations within the contracted budget
- Enforce program guidelines and project-specific procedures
- Supervise operational staff and coordinate team activities
- Assist in developing program metrics and identifying efficiencies
- Monitor program metrics for adherence to service-level agreements
- Resolve complex, escalated, and unresolved cases
- Participate in interviewing and evaluating employees
- Train employees and create or update training materials and procedures
- Translate decisions and discussions into documented workflow processes
- Develop employees and track compliance with quality, service, and program standards
- Conduct at least monthly team meetings with agendas and minutes
- Assist with presenting program information to internal and external customers
- Coordinate team goals and expectations with managers
- Develop policies, procedures, and business work plans with the Program Manager
- Recognize, recommend, and implement operational improvements
- Perform other duties as assigned
Requirements
What you’ll need- Associate or Bachelor’s degree in relevant discipline or equivalent work experience
- Five (5) or more years of relevant experience in pharmacy benefit management, specialty pharmacy or patient support/access (HUB) services preferred
- Three (3) or more years of relevant experience in pharmacy and/or medical benefit verifications, prior authorization and/or appeals required
- Customer service experience required
- Call center experience preferred
- Strong computer skills with specific aptitude in Microsoft Office
- Excellent verbal and written communication and presentation skills
- Strong analytical and problem-solving skills
- Ability to lead and develop a successful team required
- Ability to work a flexible schedule
- Ability to travel as needed
- Ability to actively participate in in-person and virtual meetings/events (internal and external)
- Supervisory responsibility for 1–20 direct reports
Benefits
Comp & perks- Remote opportunities
- Competitive salaries
- Growth opportunities for promotion
- 401K with company match
- Tuition reimbursement
- Flexible work environment
- 20 Days PTO (Paid Time Off)
- Paid Holidays
- Employee assistance programs
- Medical, Dental, and vision coverage
- HSA/FSA
- Telemedicine (Virtual doctor appointments)
- Wellness program
- Adoption assistance
- Short term disability
- Long term disability
- Life insurance
- Discount programs