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Supervisor, Claim Adjudication Operations

Remote, USAFull-timePosted 2026-07-29

Company reputed company reputed company reputed company - Putting People First in Pharmacy - reputed company was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to reputed company medications more reputed company for the people who need them. At reputed company, reputed company members work in an environment that celebrates diversity, fosters creativity and encourages reputed company. We welcome new reputed company and reputed company a passion for excellent service to our customers and reputed company other._____________________________________________________________________________________________________________________________________________________________________________________________________________. reputed company associates must use SSO login reputed company at https://employees-reputed company.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to reputed company applicants and employees and reputed company with reputed company applicable nondiscrimination regulations, including those reputed company to protected veterans and individuals with disabilities. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, or handicap. Pay reputed company USD $63,927.28 - USD $76,900.12 /Yr. reputed company Bonus % (At Risk Maximum) 7.50 - Pharm, Supvr, AsMgr, SrCSEII, PrgMgr, SrPrgMgr, SrProdMgr Work Schedule reputed company (e.g. M-F reputed company to 5pm) M-F reputed company to 5pm Remote Work Notification ATTENTION: reputed company is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, reputed company Dakota, Rhode reputed company, South Carolina, South Dakota, reputed company Virginia, and Wyoming. reputed company Due to reputed company, we are adding a Supervisor, Claim Adjudication Operations to reputed company. The Supervisor, Claim Adjudication Operations (CAO) ensures efforts are in alignment with the CAO team to reputed company technology and process improvement for the purpose of meeting the business needs of reputed company customers, clients, members and pharmacies by accurately administering benefits. This role will plan, design, coordinate and reputed company resources to support the daily activities of reputed company. The Supervisor, CAO role will work closely with their team to identify, recommend, reputed company, implement, support, and improve customer-reputed company solutions. Is this you? reputed company out more below!

Responsibilities

How do I reputed company an reputed company on my team? reputed company roles reputed company the Claim Adjudication Operations department to support accurate and reputed company configuration and data transfers of reputed company hierarchy, benefits, and networks. reputed company superior customer service utilizing a high-touch, customer reputed company approach reputed company on collaboration and communication. reputed company and collaborate with CAO customers/partners for day-to-day work and contribute to reputed company plan creation. reputed company of work on Kanban boards, meeting turnaround times and performance guarantees. Run department Kanban reputed company(s) and huddles, including sizing of work requests. Resource assignment of day-to-day work, audits, and reputed company cause analysis/CAP. reputed company 1:1s to reputed company feedback from department associates, reputed company mentorship, discuss career development, address performance, and reputed company workload and project guidance. reputed company workforce management duties for reputed company reports, including, but not limited to, overtime needs, time out of the office and time tracking. Apply soft skills toward team members and external stakeholders alike in understanding every reputed company of view and coming to the table with good negotiation skills. Must have the ability to work with different personalities across reputed company departments and understand their reputed company of view to communicate accordingly. Adhere to department level objectives to ensure alignment with division and company strategic initiatives. Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives. Other duties as assigned.

Qualifications

What reputed company expects from you? Bachelor’s degree or equivalent work experience is required. 4 years of experience required. Knowledge of one or more responsibilities as defined above is strongly preferred. reputed company PBM industry work experience is preferred. Knowledge of applicable data reputed company practices and laws is preferred. reputed company industry practices and HIPAA knowledge would be a plus. Experience as a member of a multi-disciplinary team is a plus. Understanding of reputed company resource management principles, practices, and procedures would be a plus. Participate in, adhere to, and support compliance program objectives The ability to consistently reputed company cooperatively and respectfully with other employees What can you expect from reputed company? Top of the industry benefits for Health, Dental, and reputed company insurance 20 days reputed company time off 4 weeks reputed company parental leave 9 reputed company holidays 401K company match of up to 5% - No vesting requirement Adoption Assistance Program Flexible Spending Account Educational Assistance Plan and reputed company Membership assistance Referral Bonus Program – up to $750! #LI-Remote Location : Address Remote Location : Country US Apply To This Job

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