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Coverage Determination Analyst Mentor

RxBenefits is hiring! We are adding resources to the Coverage Determination Analyst (CDA) team in Birmingham, AL headquarters. This role will support the Prior Authorization Review Team (PART) leadership by helping to drive successful behaviors through coaching, planning, and offering feedback. This role will be responsible for developing CDAs to align with the corporate service model and consistent quality standards through effective coaching and mentoring. This role with assisting with the onboarding of new hire classes and continuing education of the CDAs to ensure the continued development of the CDA team members. The CDA Team Mentor will work with the CDA Team Lead to ensure the CDA team members are meeting the PART team key metrics. The CDA Mentor will identify the learning opportunities in the CDAs' workflows and processes. Will work with the CDA Team Lead to develop learning plans to process improvements.

Job Responsibilities Include:

• Understanding of the Prior Authorization Review Process
• Understanding of the duties of the CDA workflows and tasks
• Working well in a team environment, including the PA team, member and client services teams, account management team, clinical team, and others throughout the organization
• Understanding of the current team workforce vs. incoming tasks and output process to ensure efficient workflow and adequate team member contribution for each CDA assignment
• Work with Team Lead to ensure that team members obtain the appropriate training and support to best apply their knowledge and skills on the job
• Providing input to the CDA Team Leader to establish annual individual goals
• Understanding of expectations set to meet all individual and team goals
• Conducting frequent and regular touchpoints with technicians as appropriate to address any roadblocks and recognize outstanding efforts
• Identify and document any knowledge and performance gaps within the individual CADs.
• Work with Team Leader to develop a training and improvement plan for individuals.
• Mentor individual to help to meet the outlined training and improvements milestones
• Identify and develop learning for any performance gaps, improvement opportunities for the CDA team functions.
• Participate and lead mentoring activities as assigned by Management, Team Leader, and Rx Benefits Leadership Development Team.
• Assists Team Lead in performing ongoing reinforcement to keep staff motivated and optimize performance.

Required Skills/Experience Include:

• Bachelor's degree Education or equivalent work experience
• Pharmacy/Medical prior authorization reviews experience
• Coaching or training or team leadership is plus
• Exceptional Verbal Communication skills
• Working knowledge of MS Office
• Knowledge of telephone equipment and relevant computer programs
• Knowledge of performance evaluation procedures
• Outstanding communication and negotiation abilities
• A results-oriented approach
• Excellent organizational and leadership skills
• Ability to work under pressure

Preferred Skills/Experience Include

• Workforce Analysis experience
• Keeping an active and unrestricted professional license in his/her state of residence- preferred pharmacy technician license
• Maintaining professional knowledge and development which is useful for his/her coverage determination function