Supervisor, Coverage Determination

📋 Description

• Support oversight of the Coverage Determination team.
• Assist specialists with incoming Commercial and Medicare cases.
• Ensure determinations resolved timely and accurately.
• Learn and collaborate on regulatory changes at state or federal level.
• Guide KPI and quality monitoring within regulations and contracts.

🎯 Requirements

• 6+ years in coverage determination; 1+ year leading a team.
• Current Pharmacy Technician license.
• Associate or bachelor's degree as Pharmacy Technician required.
• Bilingual: Spanish and English.
• Knowledge of CMS/Medicare and PBM operations.
• Excellent written and oral communication.

🎁 Benefits

• Flexible hybrid work model with on-site days in PR.
• Equal opportunity employer; inclusive culture.
• E-Verify participant; no visa sponsorship.
• Diversity, equity and inclusion commitment.