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Medicare Part D Support Staff Sr.Team Lead

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POST DATE 9/17/2016
END DATE 1/1/2017

Blue Cross and Blue Shield of North Carolina Winston Salem, NC

Winston Salem, NC
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
High School Diploma or GED



Join our Part D Support team as a Team Leader focused on assisting clinical pharmacist making coverage determinations for Medicare Part D medication reviews. This role will be responsible for working directly with Corporate Pharmacy Operations in supporting the review of Part D medications. The team leader will monitor daily folder volumes and assignments. This person will use Workday, field glass and Cover My Meds daily. The team leader will be responsible for reporting, monitoring, compliance of the part D support staff.

Responsible for leading a group of departmental personnel; including coaching, development, trend analysis, and team goal creation. Will review and analyze complex staffing data to identify and then resolve issues. Will also participate in enterprise-wide corporate projects.

* Manage day-to-day business area activities; provide leadership and direction to team and set team goals and expectations.

* Act as a technical resource for team; provide assistance on system issues, work processes and procedures.

* Train team members to ensure less experienced employees are able to respond professionally, courteously, quickly and accurately to all inquiries from internal and external customers.

* Provide coaching and development feedback to team.

* Work with other departmental teams to review and set performance goals and track performance against these goals.

* Identify trends, determine root causes, and initiate appropriate action to resolve issues.

* Conduct random audits of team s work. Review audit results with employees and create performance improvement plans as necessary.

* Handle complex employee relations issues. Present specific plans to management to recommend how to best address difficult issues.

* Interpret and analyze complex data from staffing models and other sources to identify issues and make recommendations for effective solutions. Develop resource allocation strategies to meet changing business demands.

* Lead and represent the department on corporate projects that require independent, sound decision making and broad based understanding of effects on the department as a whole.

* Assist with the development of less experienced team leaders.

* May develop short and long-term service objectives and methods, implement these methods when approved.

* Respond quickly and accurately to escalated issues from clients and customers.

* Review customer needs and delivery commitments and review with team members.


High school diploma or GED and 5 years of experience in an operations function to include training, auditing or technical support. 2 of these years must include experience as a team leader or in a supervisory role.

For SMA Customer Service the incumbent will be required to obtain the North Carolina Department of Insurance Agent/Medicare Supplement Long Term Care license within the first 60 days of employment.


Bachelor s degree in a business or health-related field.

Experience in a health care/health insurance environment.

Experience in claims, customer service, membership, enrollment or a call center environment.

Experience managing a project.

* Thorough knowledge of BCBSNC products and procedures

* The ability to interpret policy provisions

* Effective verbal and written communication and presentation skills

* Commitment to high quality customer service

* Ability to coach and give constructive feedback

* Ability to promote and support team work and team decision making

* Ability to identify issues and recommend and implement solutions

* Ability to make sound and independent business decisions in often high-pressure situations

* Excellent interpersonal and relationship building skills

* Strong time management and organizational skills

* Ability to foster meaningful learning opportunities for each staff member

* Strong data analysis skills

Certified Customer Service Associate

Certified Claims Coder.