Occam Health Services is at the leading edge of healthcare services, helping patients and their physicians find the right resources and therapies on behalf of our biopharma clients. By combining state-of-the-art technologies with clinical value based programs and services, Occam Health delivers cost efficient and innovative solutions today and advances the frontier of what is possible tomorrow.
Title: Program Manager
Category: Customer Support
Type: Exempt, Full Time
Job Nature: Office based: Oversee operation of call center based customer service programs.
Job Summary: Oversight of all staff and activity of the reimbursement hub program to which the employee is assigned. Includes day-to-day operations interaction with Director/Executive level client contacts. Resolution of escalated cases/issues.
- Act as primary point of contact for Director/Executive level client contacts.
- Manage day-to-day activity of the hub program(s) to which the employee is assigned.
- Prepare client facing and internal reports, as required. Review and resolve denied or underpaid insurance claims.
- Develop, implement and train direct reports on program specific Standard Operating Procedures (SOPs).
- Document all activities in program database within required timelines.
- Research, monitor and update payer prior authorization requirements and coverage policies for specified client program.
- Provide on-going performance feedback to all direct reports, as required.
- Complete probationary and annual reviews for all direct reports.
- Provide coaching, mentoring and implement Performance Improvement Plans, as necessary.
- Hold team meetings, encourage open interaction and foster high employee satisfaction.
- Assist with client contract management/development, as requested.
- Host conference calls with Director/Executive level client contacts as required by program guidelines.
- Develop and implement quality monitoring and quality assurance tools for assigned program(s).
- Interview and hire qualified staff.
- Assist with business development activities (requests for proposal), as requested.
- Travel to and attend client meetings, off site training, and/or conferences. Travel time estimate: up to 50%, depending on assigned program(s).
Training, Education, Experience Requirements:
- Must be 18 years old or older.
- Bachelor’s degree or relevant experience.
- Minimum four years recent healthcare experience (3 years direct industry preferred).
- Expert knowledge of medical insurance (public and commercial), billing and coding and associated terminology.
- Exhibit proficiency in Microsoft Office products.
- Excellent customer service skills (call center experience required).
- Advanced problem solving, research and analytical skills. Advanced communication skills, both written and verbal. Advanced client interaction experience required.
- SOP development experience required. Staff training experience required.
- Supervisory experience required. Interview and hiring experience preferred.
Job Relationships: Works with varying levels of staff and in direct contact with consumer/client.
Time Commitment: Normal office hours, 8:30AM through 5:30PM, Monday through Friday. Minimum 40 work hours Full Time, may be required to work over 40 hours per week to meet business needs.