Note: The job is a remote job and is open to candidates in USA. CareMetx provides patient access solutions and support services that help patients start and remain on specialty therapies through digital hub services and reimbursement support. The Operations Manager oversees a pharmaceutical hub reimbursement operations program, ensuring contractual compliance, program quality, staff development, client communication, budgeting, and operational effectiveness.
Responsibilities
- Ensures team is meeting contractual obligations
- Design programs and Training content which promote high motivation among team members
- Conducts performance reviews and rewards positive behavior
- Coaches, counsels, and sets goals for supervisors to help develop them for career progression
- Provides day-to-day instructions to team members on job responsibilities
- Helps associates resolve associate work-related issues
- Supports new associates in their efforts for growth and development
- Participates in the hiring and termination process
- Develops designs and conducts Train the Trainer program
- Provides feedback up and down the organization (Positive and Constructive)
- Participates in client meetings; prepares agenda and / or takes meeting notes
- Ensures open communication with program support
- Translates and oversees organizational strategies for assigned goals
- Identifies client issues; receives and triages client requests
- Proactively identifies program issues and proposes ways in which to address their concerns
- Maintains positive rapport with client
- Understands the billing process and contractual obligations
- Participates in budget planning
- Accountable and responsible for program quality and compliance with standard operating procedures
- Designs project task plan and standard operating procedures
- Develops and maintains program SOPs, Work instructions and Job Aids
- Analyzes reports for trends and gives recommendations
- Analyzes progress of tactical issues
- Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)
- Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled
- Performs other related duties as assigned
Skills
- Minimum 5 + years' experience in the pharmaceutical/healthcare industry
- Minimum 4+ years reimbursement management experience ( reimbursement hub, specialty pharmacy, physician's office, medical insurance, healthcare setting, and/or related experience)
- Minimum 3+ years direct people management experience
- Minimum 2 + years cell/gene therapy
- Minimum 2 + years experience/exposure to pediatric patients & CareGivers
- Ability to travel (overnight) up to 20% of the time within all territories (East, Central, Mountain, Pacific)
- Schedule flexibility to be able to provide backup coverage for program operations and covering Case Manager responsibilities in the event of planned/unplanned absences
- Strong interpersonal skills and attention to detail
- Ability to communicate effectively both orally and in writing
- The ability to manage multiple tasks
- Working knowledge of Microsoft Office
- Ability to resolve associate issues effectively and efficiently
- General knowledge of reimbursement, patient assistance programs, database elements and functionality; operational policies and processes particularly distribution processes / interfaces
- Proven ability to appropriately escalate issue to management
- Health care research and analysis skills sufficient to support payer research, healthcare policy library and state management
- Demonstrated player/ coach mindset with a willingness to answer calls, work cases and rotate the late shift coverage
- Demonstrated ability to be a primary client contact
- Ability to set program goals and work independently
- Bachelor's Degree (general business, health sciences, public policy, or other related degrees) preferred
- Licensed Social worker, Patient Advocacy or equivalent experience preferred
Company Overview
Company H1B Sponsorship