Supv, Access

Amerita

The Supervisor Access is responsible for overseeing all aspects of patient access services including prior authorization benefit investigation and claims adjudication. This role ensures timely and accurate completion of benefit verification authorization requests copay assistance coordination and payer communications to support patient access to therapy. The Supervisor will lead a team within the Access vertical providing staffing direction quality oversight process improvement and training to ensure productivity goals and service standards are consistently achieved.

The role requires advanced knowledge of payer requirements authorization processes insurance benefits and pharmacy operations. The Supervisor Access partners closely with pharmacy leadership intake and clinical teams to resolve escalations implement best practices and drive operational excellence.

Schedule:
Monday - Friday 8:30 am-5 pm MST

We Offer:

Competitive Pay

Health Dental Vision & Life Insurance

Company-Paid Short & Long-Term Disability
Flexible Schedules & Paid Time Off
Tuition Reimbursement
Employee Discount Program & DailyPay
401k

Pet Insurance

• Supervises Access staff (Prior Authorization and Benefit Investigation) to maintain a positive and productive work environment fostering teamwork engagement and retention
• Recruits selects trains evaluates and coaches staff; provides ongoing performance management including corrective actions and development planning
• Manages daily workflow assignments and staffing to ensure timely completion of benefit verification and prior authorization requests
• Provides oversight and feedback for on-site and off-site teams
• Monitors adherence to policies procedures and productivity standards; audit cases for accuracy compliance and quality
• Analyzes workflow queues and trends (e.g. rejections No-Go cases appeals escalations) to identify opportunities for process improvements
• Partners with pharmacy leadership to design approve and implement workflow enhancements and operational initiatives
• Ensures compliance with all state/federal regulations and patient confidentiality requirements
• Serves as a subject matter expert for benefit verification prior authorization payer portals copay assistance programs and claim adjudication
• Oversees completion of insurance verification including pharmacy and medical coverage prior authorization initiation and documentation of outcomes
• Handles escalated or complex cases working with payers prescribers and patients to resolve access barriers
• Provides guidance to providers and patients on documentation appeals and payer requirements
• Communicates effectively with pharmacy operations nursing corporate teams prescribers and patients to resolve issues and share updates
• Partners with leadership on reporting metrics and strategic initiatives related to Access services
• Supports training initiatives system access and troubleshooting of web tools (e.g. CoverMyMeds payer portals)
• Maintains a safe clean and compliant pharmacy environment

• Supervisory Responsibility: Yes

• High School Diploma/GED required; Associates or Bachelors degree preferred
• 4 years of pharmacy benefit verification or prior authorization experience required
• 1 years of supervisory or leadership experience required (2 preferred)
• Specialty pharmacy experience strongly desired
• Advanced knowledge of prior authorization processes benefit investigation payer coverage requirements and pharmacy insurance claims
• Familiarity with Medicare Medicaid and commercial insurance plans
• Strong leadership coaching and team development skills
• In-depth knowledge of pharmacy insurance benefit verification prior authorization platforms and claims adjudication
• Excellent interpersonal and communication skills; able to work across all levels of staff and management
• Ability to manage multiple priorities in a fast-paced environment
• Strong organizational analytical and problem-solving skills
• High attention to detail with commitment to accuracy and compliance
• Percentage of Travel: 0-25%
• Driving Position: No

**To perform this role will require frequently sitting standing walking and typing on a keyboard with fingers and occasionally bending reaching and climbing (stairs/ladders). The physical requirements will be the ability to push/pull and lift/carry 1-10 lbs**