Director of Benefits Verification

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The primary responsibilities of the Director of Benefits Verification is to oversee all Benefits Verification across multiple sites in the Specialty organization which includes accountability for service performance, customer satisfaction, financial performance, and regulatory compliance. 

Responsibilities of the Director of Benefits Verification: 

  • Accountable for leading the management team with respect to benefits investigation including internal and external payers, major medical and electronically adjudicated payers, including prior authorizations, where applicable. Responsibilities include service performance,customer satisfaction and financial performance. The Director of Benefits Verification will lead the team of managers that make up a team of 600+ staff colleagues. 
  • Collaborates with other functional areas to support operational and financial objectives of the specialty pharmacy services group as it relates to day-to-day pharmacy operations. Acts as the subject matter expert for cross functional collaborative efforts. 
  • Provides effective leadership and direction to all direct reports while managing and fostering a dynamic and progressive work environment characterized by high integrity, productivity, quality, and a commitment to excellence and respect.
  • Develops staffing plan for the department in collaboration with recruiting and human resources. 
  • Facilitates effective communication within the organization and with other departments that may interact with the Benefits Verification Department. 

Required Qualifications of the Director of Benefits Verification:

  • 10+ years of operational leadership experience in managing multiple operations, teams, and business processes in a healthcare environment, which includes oversight and accountability of financial budgets, financial goals and planning. 
  • Specialty Pharmacy and/or billing and reimbursement experience is strongly preferred.

Education of the Director of Benefits Verification:

  • BS/BA Degree in related field 

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