Aetna

Supervisor-Prescription Records

Posted on: 15 Mar 2021

Lincoln, RI

Job Description

Job Description
The Prescription Records Supervisor is responsible for the personnel and operational supervision of a team of approximately 20 production agents supporting the processing of requests for patient and prescriber prescription records. Responsibilities include agent performance; qualitative and quantitative KPIs, coaching and development, quality, and efficiency. Consistent application of policies, procedures, and compliance with HIPAA regulatory requirements. Manages the day to day operations, advanced issues, and escalations.
- Development of a high performing team of agents: Responsible for the personnel and operational management of 20 agents processing of patient PHI requests to satisfy time sensitive regulatory demands, subpoenas, attorney, third party, and patient prescription record requests in accordance with state and federal HIPAA/Privacy requirements. Ensuring qualitative, quantitative results, along with the efficiency of agents production and their alignment with KPIs. Coaching and development of agents to create a high caliber engaged team.
- Operations: Responsible for the day to day prescription records operations, overseeing the processing of patient prescription records for customers, attorneys, subpoenas, and regulatory agencies along with ensuring operational SLAs are met. Handles advanced escalations and senior agent inquiries, responsible for daily task assignments and production monitoring to manage production needs.
- Problem Solving: Effective triaging of highly sensitive and time sensitive legal documents to the correct parties for completion and or review. Consistent application of policy, procedures, and compliance with regulatory requirements and demands. Researches outstanding requests or calls that are escalated internally as well as from customers, regulatory agencies, etc. to provide an acceptable resolution to the situation in an efficient and timely manner.
- Personnel Management: Adherence to HR policies and procedures, interviewing and selection of agents, coaching and development, and annual employee reviews.
- Work closely with management and the IS team to improve the system and tools and/or any new system applications or projects. Quality assurance testing of newly implemented changes.
- Reporting: Maintain operational spreadsheets and trending issues/concerns.

Required Qualifications
- Prior legal, records related, compliance, or pharmacy experience.
-- 1 or more years previous supervisory or equivalent experience in a progressively responsible role.
- Ability to multi task and quickly resolve issues in a fast paced environment.
- Strong communication skills and ability to motivate others.
- Coaching, mentoring and development skills.
- Proficiency MS suite of tools: PowerPoint, Excel, Teams. etc. with ability to create and present data to targeted audiences, both internal and external, in a professional manner.
- Self-directed with strong analytical, problem solving, and interpersonal skills.

Preferred Qualifications
- Bachelors Degree in related field.
- Legal or regulatory experience in pharmacy.
- CPHT-national pharmacy technician certification

Education
- Associate degree or equivalent.

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Aetna

Hartford, CT

Aetna Inc. operates as a health care benefits company in the United States. It operates through three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment offers medical, pharmacy benefit management service, dental, behavioral health, and vision plans on an insured and employer-funded basis. It also provides point-of-service, preferred provider organization, health maintenance organization, and indemnity benefit plans, as well as health savings accounts and consumer-directed health plans.

In addition, this segment offers Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers’ compensation administrative services, and products that provide access to its provider networks in select geographies. The Group Insurance segment offers life insurance products, including group term life insurance, voluntary spouse and dependent term life insurance, group universal life insurance, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which provide the benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities.

The Large Case Pensions segment manages various retirement products comprising pension and annuity products primarily for tax-qualified pension plans. The company provides its products and services to employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is based in Hartford, Connecticut. As of November 28, 2018, Aetna Inc. operates as a subsidiary of CVS Pharmacy, Inc.

 

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