Now Optics

Managed Care Supervisor

Job ID
2020-21551
Location
Operation Palm Springs, FL (Support Center)
Schedule Type
Full Time
Category
Insurance

Overview

At Now Optics, our Managed Care Supervisor provides strategic leadership, financial and administrative oversight of the Managed Care Department. In this role you will integrate with the Director Managed Care, to create strategies to drive the Managed Care sales in existing and new retail locations. You will oversee the facilitation of contracting, credentialing, automated processes, and training for the Managed Care department. All while following all policies and procedures as outlined by our company and/or governmental regulations in accordance with HIPAA regulations.

 

About Us:

Now Optics is one of the most innovative and fastest growing optical retailers in the United States and a leader in the attractive convenience and value segment of the U.S. eyecare industry. Our vision is to change the way people buy eyeglasses and receive eyecare services. We’ll achieve our vision by continuing to leverage technology to improve access, product types and cost.

The Supervisor of Managed Care shares and supports our Vision, Mission and Values, including:

Vision: Modernizing the eye care experience for all people

Mission: Making eye care easy

Values: iCARE

Integrity: We see integrity as building a foundation of trust with our customers, employees and stakeholders by communicating honestly, ensuring consistency and delivering on our commitments. 

Collaboration: We see collaboration as combining the talents of a diverse group, offering proactive communication and being open-minded to new ideas.

Accountability: We see accountability as taking initiative, delivering our best in all we do, accepting responsibility for our actions and taking ownership of results. 

Respect: We see respect as prioritizing human relationships, being present, connecting with transparency and empathy. 

Empowerment: We see empowerment as making purpose-driven decisions to support the company vision, showing appreciation for others, and taking care of the individuals we serve.

Responsibilities

Duties & Responsibilities

  • Improve and update procedures and processes related to the policy to ensure excellent delivery of insurance services within the retail locations
  • Develop Managed Care training material as needed to support corporate and franchise locations
  • Resolve escalations of Managed Care situations and audit requests from insurance carriers
  • Coordinate malpractice insurance renewals for Dr. Campen and Dr. Newton
  • Must be in contact with Training Department and Executive Management to discuss new procedures or provide any other assistance as it relates to Managed Care procedures
  • Must be able to identify and analyze risks associated with any policy and suggest solutions to minimize risks
  • Review insurance remittance and fee schedules to investigate inconsistencies in the policy (denials)
  • Assist Director – Managed Care with any potential new contracts
  • Proactively supports management as well as the objectives and goals of the department
  • Collaborate weekly and monthly with Support Center leaders to gather pertinent business related items and implement into Weekly Action Review and Sales Action Planner
  • Manage the operation of assembling Store manuals with Managed Care information for all new store openings
  • Provide productivity and tracking of new/outstanding items for credentialing and timeline on completion
  • Work with IT and Director, Managed Care on IT/Managed Care initiatives
  • Facilitate the New Store Opening cash drawer checks, gift cards and store decal process
  • Managed the refunds process for insurance and managed care patient refunds
  • Deposit insurance and franchise checks as needed
  • Create and update Managed Care SOP’s as needed
  • Supervise the insurance mail process by ensuring insurance checks are routed and deposited appropriately.
  • Navigating payer websites 
  • Additional duties as needed or instructed

Qualifications

Requirements:

  • Bachelor's degree, Experience in Managed Vision Care in lieu of degree
  • 3+ years in a Managed Care environment
  • Knowledgeable on retail systems, HR practices and retail operations
  • Strong Excel skills 

 

Key Qualifications:

  • Advanced problem solving abilities
  • Excellent communication and organizational skills
  • Attention to detail with the ability to prioritize and execute tasks efficiently
  • Ability and drive to thrive in a fast paced environment with shifting priorities
  • Ability to prioritize tasks effectively
  • Ability to accomplish tasks through others (delegate)
  • Comfortable learning new systems and navigating through proprietary software 
  • Eligibility to work in the United States

 

Now Optics is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. All employment decisions at Now Optics are based on business needs, job requirements and individual qualifications, without regard to actual or perceived race, color, religion, sex (including pregnancy), national origin, age, disability or certain classifications based on genetic information, or any other characteristic protected by federal, state, or local laws, regulations or ordinances.

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