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Supervisor, Coverage Determination at Abarca Health - ApplyBlast

Supervisor, Coverage Determination

Abarca Health

2 months ago

3.8 on Glassdoor

San Juan, Puerto Rico, United States

Hybrid

Full Time

Manager

0 applicants

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About this role

The Supervisor, Coverage Determination will oversee and support the Coverage Determination team, ensuring that commercial and Medicare cases are resolved accurately and on time. This role involves monitoring performance metrics, coaching staff, managing schedules, and ensuring compliance with CMS and client regulations.

Responsibilities

Monitor calls and cases to ensure timely resolution and quality
Achieve key performance metrics for coverage determination cases
Support pharmacists by gathering information for exception requests
Prepare team schedules considering workload and personnel availability
Ensure compliance with CMS policies and other regulatory entities

Skills

Qualifications

Certified Pharmacy Technician License

About Abarca Health

abarcahealth.com

Headquarters

San Juan, San Juan, Puerto Rico

Company Size

501-1000 employees

Founded

2005

View Profile

Abarca Health is a technology-driven pharmacy benefit manager (PBM) that has combined with LucyRx to form Healthcare Revolution Partners, serving 9 million+ members across the U.S. The company offers innovative PBM solutions powered by its next-generation Darwin™ platform, along with Assura, a net cost guarantee pricing solution that brings transparency and predictability to drug spend management. Abarca serves health plans, employers, and public programs with a focus on reducing costs, improving patient outcomes, and delivering a seamless, personalized pharmacy experience.