Executive Lead

This is a fully remote position, open to applicants in Connecticut.

📋 Description

• Oversee and lead a team of patient access specialists to meet departmental objectives

• Evaluate and interpret data within the Salesforce platform to pinpoint opportunities for enhancement and efficiency

• Accountable for the team's key performance indicators (KPIs)

• Provide training and mentorship to newly hired patient access specialists

• Conduct audits on a selected number of cases per program as directed by the Director of Patient Access

• Collaborate closely with other Executive Leads and the Director of Patient Access to refine and enhance operational best practices

• Sustain open lines of communication with the Strategic Account Manager for each assigned program, working together on weekly program reviews, calls, and addressing frequent inquiries or concerns

• Elevate issues to the program's Strategic Account Managers as necessary

• Handle a caseload for a designated program

• Perform data entry and review of new patient cases in the system database

• Regularly communicate with physicians' offices and their staff

• Ensure accurate and current records are maintained within the Salesforce platform for precise client reporting

• Execute the full patient access process as defined by program SOP, including analyzing and interpreting patient clinical data, clinical notes, and files to verify that medical necessity criteria are met according to each payer policy

• Assess multiple insurance policies to establish medical necessity criteria to support medical device/procedure(s)

• Ensure adherence to all regulatory and company policies

⛳️ Requirements

• A college degree is preferred, but relevant work experience can be considered as a substitute

• A minimum of 5 years of experience in healthcare authorization, with at least 2 years in a supervisory position

• Comprehensive understanding of insurance processes, medical terminology, and healthcare regulations

• Strong leadership abilities, along with analytical and problem-solving skills

• Exceptional communication and interpersonal skills

🏝️ Benefits

• Health insurance

• Paid time off

• Professional development