Overview:
The Operations Support Coordinator (OSC) plays a vital role in ensuring the accuracy, timeliness, and efficiency of key operational workflows that support member care. This position is responsible for managing essential administrative and clinical-adjacent functions such as medication prior authorizations, toxicology result entry, virtual direct observed testing oversight, clinical and operational scheduling, and program coordination for self-pay members.
The OSC ensures that all tasks are completed in accordance with organizational standards, regulatory requirements, and established timelines to promote a seamless care experience.
Schedule:
Monday: 12:00p-8:00p EST
Tuesday - Friday: 9:00a-5:00p EST
Pay: $45,000 - $56,000
Responsibilities:
Essential Functions:
Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.
- Responsible for preparing and submitting medication prior authorization requests and renewals.
- Investigate and resolve payer responses; communicate outcomes to appropriate teams; document actions in the EMR.
- Coordinate administrative duties such as prescription creation, attendance, payment collection, etc., as part of the Safety Net Program, and ensure program protocols are followed.
- Monitor and ensure procedural compliance for virtual Direct Observed Toxicology collections via oral swabs, troubleshooting and escalating issues as they arise.
- Responsible for accurate and timely entry of toxicology results, including confirmatory and state-specific (e.g., Kentucky) results.
- Collaborate with field clinical & operational teams to investigate and resolve workflow or data discrepancies.
- Maintain accurate medication records and compliance by processing prescription cancellations as needed.
- Ensure Accuracy in Data Management.
- Audit and maintain member information within the EMR system to ensure data integrity and compliance.
- Identify and communicate process improvement initiatives to enhance member care.
- Provide flexible and responsive support to Care Teams with additional administrative duties as assigned.
- Support clinical and operational scheduling, including staff and group coverage assignments.
- Provide timely, professional communication to internal teams, members, and external partners.
Other Duties and Responsibilities:
- Other duties as assigned.
Qualifications:
Knowledge, Skills and Abilities:
- Fluency with Google Suite (Sheets, Docs, Meet, Drive, etc.) and Microsoft Office applications
- Familiarity with electronic medical records (EMR) systems
- Ability to troubleshoot minor technological challenges and learn new software systems or processes as needed.
- Exceptional accuracy in data entry while maintaining productivity.
- Strong ability to prioritize tasks and manage complex administrative duties with attention to detail while meeting deadlines with little supervision.
- Ability to manage confidential and highly sensitive information in compliance with HIPAA and 42 CFR Part 2 guidelines.
- Ability to troubleshoot issues, identify solutions, appropriately escalate concerns, and adapt to new challenges effectively.
- Ability to work independently and as part of a team to achieve shared goals and maintain operational efficiency.
- Exceptional verbal and written communication skills, including the ability to effectively communicate data-related issues and solutions to team members or supervisors.
- Willingness to work evenings as needed to provide appropriate member care.
Qualifications & Requirements:
- High school diploma or equivalent required
- Associate’s degree preferred, or 2+ years of relevant experience
- At least 1-2 years of experience in healthcare administration or a similar administrative role.
- For remote roles, access to reliable internet and telephone services, specifically 50M download and 10M upload packages or higher as well as a strong WiFi signal from your remote work location.
- Must meet pre-employment requirements and maintain all applicable state and job-related guidelines for background screening. Depending on state-specific requirements, this may include fingerprinting, drug testing, health screening, CPR/Basic First Aid, and license/credential verifications.
