Envision Options

  • Canton, OH, USA
Nov 30, 2021
Envision Options Remote * (PO Box 60173, Philadelphia, PA 19102, USA)
The Lead Pharmacy Member Customer Service Representative is responsible for providing timely, knowledgeable and courteous resolution and response to pharmacy, member and product related inquiries, providing department wide training, and supporting the help desk supervisors and managers. This position has no direct reports. Department:Commercial/Medicare Operations Supervisor:Supervisor Customer Service Pharmacy Member Help Desk Exemption:Non-Exempt ESSENTIAL DUTIES AND RESPONSIBILITIES: • Assist staff with resolving issues from members, providers and pharmacies • Respond to routine inquiries on multiple products from members, providers, pharmacies, and employer groups • Answer calls that may require escalation in the absence of the supervisor • Research required information using available resources • Route calls to appropriate resource • Utilize multiple company database programs for accessing member information • Document all call information according to standard operating...
Nov 29, 2021
Envision Options Remote * (PO Box 60173, Philadelphia, PA 19102, USA)
ESSENTIAL DUTIES AND RESPONSIBILITIES: Maintain knowledge of government and commercial enrollment and disenrollment guidance. Ensure compliance with all correspondence and enrollments Implement and maintain appropriate oversight of enrollment, disenrollment, and information requested based on client needs and/or in compliance with Medicare guidelines Collaborate with Customer Care Department regarding eligibility, enrollment, disenrollment, and payment changes to ensure customer satisfaction and compliance Actively partner with the Information Technology team to develop the systems and tools required to achieve operational excellence Lead, guide and enforce overall performance and engagement strategies for enrollment and billing teams. Guide direct report teams in identifying and resolving performance and control gaps Develop operational plans with defined performance standards, metrics and action plans that can be tracked against timelines to evaluate organizational...
Nov 29, 2021
Envision Options Remote * (PO Box 60173, Philadelphia, PA 19102, USA)
ESSENTIAL DUTIES AND RESPONSIBILITIES: Ensure accuracy of PDE creation by testing and performing quality control measures Assist in PDE standards development and development of related documentation and training materials Review PDE records and PDE base table information to ensure accuracy and overall format compliance Batch process and ensure claims impacted by Retro Fx transactions and/or Retro LIS movement are corrected Administration of the Retro LIS process (RLB) Troubleshoot Medicare PDE issues and audits and ensure successful adherence to annual CMS deadlines Create, distribute and resolve monthly and bi-monthly PDE error reports Adhere to internal timelines for PDE development, testing and new standards implementation Perform regression testing analytics associated with established PDE logic and protocols Perform user-acceptance testing (UAT) for new PDE and Medicare Cornerstone logic Process and analyze claims as needed for PDE correction Perform...
Nov 24, 2021
Envision Options Remote * (PO Box 60173, Philadelphia, PA 19102, USA)
Vice President, Account Management The Vice President of Account Management is responsible for overseeing the account management functions of the company in accordance with the policies and practices of Elixir. This position will be responsible for developing, maintaining and monitoring client interactions while maintaining the exceptional level of professionalism and customer service standards that Elixir has attained within the pharmacy benefit management industry. This position will have a team of people with direct reporting responsibilities. Department: Account Management ESSENTIAL DUTIES AND RESPONSIBILITIES: • Oversee the job responsibilities and performance of account executives and other account management team members • Regularly review workload balance and client assignments for all team members • Assign account teams to clients and oversee client transitions when necessary • Oversee total account service to ensure that the company meets or exceeds client...
Nov 23, 2021
Envision Options Remote * (PO Box 60173, Philadelphia, PA 19102, USA)
ESSENTIAL DUTIES AND RESPONSIBILITIES: Design, develop, test and implement high quality SQL queries using SQL Server Management Studio and other system based reporting tools Review reports and content for accuracy Ensures timely resolution of defects and issues that are identified Work with operational teams and Pharma partners to create custom built data reports per the partner specifications Implements and oversees secure transfer of data between pharmacy and pharma partners Works with operations teams to create custom built data reports to support business needs Supports annual accreditation reporting efforts (URAC, ACHC, VIPPS, etc.) Provide accurate estimates for development timelines Manage relationships with reporting partners and vendors Maintain inventory of reports and oversee change control of reports as necessary with proper documentation Develops a strong working knowledge of the primary pharmacy operating systems and provides support as needed...
Nov 22, 2021
Envision Options Remote * (PO Box 60173, Philadelphia, PA 19102, USA)
ESSENTIAL DUTIES AND RESPONSIBILITIES: Serve as the relationship lead on the account, incorporating other internal staff where and when needed to the relationship; build and foster relationships with influencers and decision makers at the client to ensure client satisfaction as measured in the annual client satisfaction survey; Maintains contact and relationships with each level of the business, including executive level decision makers, to help facilitate and generate meeting and continue developing relationships to create opportunities over the short and long term Work together with other members of the leadership team, including Executive Sponsors, to develop and implement client strategies and company initiatives; Provide executive sponsor updates monthly Maintain SalesForce.com to include all relevant customer contact information, opportunities, communication strategies and other elements of the customer record. Maintain strategic plans for each client that includes...