Pharmacy Call Center Lead - Remote Mississippi

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

The Pharmacy Call Center Lead is expected to be a subject matter expert in areas of pharmacy knowledge as well as call center operations. Duties will include, but are not limited to, appropriate processing of prior authorization requests, research and resolution of escalations received at the member, provider, or pharmacy level, initial and continued training of the pharmacy technician team, ongoing quality review of the technician team to identify areas of additional coaching or improvement and working with other supervisors and managers as needed to assist in oversight and productivity of the team.

Your role in our mission

• HIPAA Compliance Champion: Ensure adherence to all Protected Health Information (PHI) protocols and regulations to safeguard patient privacy.
• Prior Authorization Efficiency Expert: Process submitted prior authorization requests efficiently within established timeframes, completing approvals that meet defined criteria without requiring pharmacist intervention.
• Communication Ace: Provide clear and consistent communication to both members and providers regarding the status of prior authorizations and address any inquiries effectively.
• Problem-Solving Superhero: Utilize knowledge and resources to resolve incoming calls on initial contact, following established standard operating procedures.
• Customer Care Champion: Deliver exceptional customer service, fostering positive interactions with members and providers.
• Teamwork & Innovation Leader: Collaborate in continuous improvement initiatives, identify process inefficiencies, propose innovative solutions, and actively participate in the adoption of new technologies.
• Leadership & Development Coach: Possess the ability to effectively lead and coach other employees, providing constructive feedback and fostering their professional growth through impactful training programs.
• Tech-Savvy Problem Solver: Have a solid foundation in computer applications including Microsoft Office, internet navigation, and email communication. Coupled with your quick learning ability, you can effectively solve problems and make sound decisions with minimal supervision.

What we're looking for

• Active pharmacy technician registration with MS Board of Pharmacy and certified pharmacy technician from accredited program (PTCB, ExCPT, etc.) or must obtain certification within 12 months
• 2 years of relevant experience as a pharmacy technician in retail pharmacy, hospital pharmacy, managed care, insurance, or pharmacy benefit management
• Knowledge of Microsoft office applications, e-mail, and computer applications required

What you should expect in this role

• Video cameras must be used during all interviews.
• Remote (work from home)
• In order to effectively work as a teleworker with Gainwell, employees Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance.

The pay range for this position is $39,100.00 - $55,900.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.