Clinical Services Manager role at DaVita, supporting clinics with safety and regulatory oversight through targeted coaching and quality initiatives. Ensuring compliance and addressing performance goals with teams.
About the role
- Case Manager at UBC advocating for patients' access to specialty pharmaceuticals. Ensuring timely coordination of case elements and communication with stakeholders while enhancing patient experience.
Responsibilities
- Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required.
- Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders.
- Communicate patient benefits and responsibility timely and accurately.
- Assess and refer patients appropriately for special programs/services when appropriate.
- Performs quality checks on cases and report trends to leadership.
- Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.
- Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy.
- Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements.
- Recognize a product quality complaint and forward caller/written information to a manufacturer.
- Other duties, as assigned.
Requirements
- Bachelor’s degree or six years of relevant working experience
- Two (2) or more years of relevant experience in pharmacy benefit management preferred
- Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred
- Proficient in Microsoft Office applications
- Knowledge of medical and claims processing terminology
- Excellent written/verbal communication to include providing clear instructions.
Benefits
- Remote opportunities
- Competitive salaries
- Growth opportunities for promotion
- 401k with company match*
- Tuition reimbursement
- Flexible work environment
- 20 Days PTO Annually (accrued)
- 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
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Service Delivery Manager responsible for client relationships and solution delivery in data center services. Overseeing operational execution and collaboration across teams.
Manager of Threat Intelligence delivering actionable insights for personnel safety at Dow Jones. Collaborating with security teams to assess risks and improve intelligence capabilities.
Business Line Manager leading Environmental operations focused on acoustics at Forcit Consulting. Drive business, develop the team, and broaden operations over time.
Assistant Manager overseeing retail store operations at AT&T. Leading a team to ensure best - in - class customer service and achieve sales objectives.
Senior Brand Activation Manager driving consumer - centric brand portfolio growth and executing trade marketing initiatives at Mondelēz International. Collaborating with cross - functional teams and managing market - specific assets.
Senior Manager of Talent responsible for implementing talent initiatives at Mondelēz International. Focused on performance, talent planning, and development to shape the organization's future success.
Manager in Transaction Advisory Services at Baker Tilly providing due diligence and transaction advisory services. Work closely with clients and firm leadership to meet complex financial needs and build the business.
Senior Manager/Principal Consultant developing strategies for manufacturing companies at TMG Consultants. Leading projects and collaborating with clients to drive innovation and operational improvements.
Device Technology Deployment Manager overseeing technology deployment projects for Roche’s device manufacturing processes. Ensuring compliance and efficiency in regulated medical device environments.