Job Description

Careers with real impact.

Every role at Orsini moves a patient closer to life-changing therapy. We partner with biopharma innovators, healthcare providers, and payers to make access simple, compassionate, and reliable - so no patient is left behind. Make your next role matter.

ABOUT ORSINI

Providing compassionate care since 1987, Orsini is a leader in rare disease and gene therapy pharmacy solutions, built to simplify how patients connect to advanced medicines. Through our comprehensive commercialization solutions including a nationwide specialty pharmacy, patient services hub, home infusion and nursing network, and third-party logistics provider, we work with biopharma, providers, and payors to ensure No Patient is Left Behind™.

OUR MISSION

Orsini is on a mission to be the essential partner for biopharma innovators, healthcare providers, and payers to support patients and their families in accessing revolutionary treatments for rare diseases. Through our integrated portfolio of services, we seek to pioneer comprehensive solutions that simplify how patients connect to advanced therapies while providing holistic, compassionate care so that No Patient is Left Behind™.

CORE VALUES

At the heart of our company culture, the Orsini LIVE IT Core Values serve as guiding principles that shape how we interact with each other and those we serve. These values are the driving force behind our commitment to excellence, collaboration, and genuine care in every aspect of our work.

LOCATION

The salary for this position is $60,000 - $65,000 per year.

This is a hybrid position at our Elk Grove Village location.

Supervises and supports a team of permanent and contingent Prior Authorization Representatives who are responsible for the data-entry of new enrollments and processing Prior Authorization. The supervisor will provide oversight for processing of claims and the resolution of all rejected medical and/or pharmacy claims. The supervisor will ensure that the team is trained and motivated. They will assist with hiring staff for incremental growth or re-staffing open positions. The role will validate the accuracy of the team's work and ensures that performance goals are met. Interfaces with a variety of internal and external customers including patients, physicians, account mangers, sales, pharmacy managers, contingent workforce managers, manufacturer representatives, reimbursement and upper management. Ensures that all HIPAA, policies/procedures and compliance requirements are met within the department.

ESSENTIAL DUTIES

• Monitors the production, volume, and quality of the work produced by the team using a variety of reports and audit tools. Makes daily adjustments to assignments to achieve maximum results. Ensures that account audits are completed daily and weekly.
• Establishes individual employee goals and provides timely performance feedback. Recognizes and rewards good performance. Addresses and resolves Human Resource issues following policies and procedures including disciplanary action. Escalates issues to HR appropriately. Completes yearly performance reviews.
• Conducts interviews, hires, trains, and motivates team. Interfaces with contingent workforce company managers. Makes certain employees have all needed tools including appropriate system access. Approves payroll for permanent and contingent workforce.
• Responsible for integration of new Specialty business for therapies handled by assigned team. Disseminates accurate information to the team.
• Functions as the main resource for questions regarding admissions policies and procedures. Resolves escalated Prior Authorizations and Specialty Benefits Verification issues. Collects and publishes data, establishes facts, draw conclusions, solves problems, and responds to inquiries. Ensures that other departments are involved when needed. Escalates IT problems appropriately.
• Responsible for helping to develop policies and procedures and process improvement strategies within the department. Communicates procedure changes to departments affected by that change.
• Perform other duties or projects as assigned.
  
  Disclaimer: The information written in this job description indicates the general nature and level of work to be performed. This job description is not designed to contain or be interpreted as totally comprehensive of every job duty, responsibility, or qualification required by an employee assigned to this job. While employed in this position, an employee may be required to perform other assignments not listed in this job description.

KNOWLEDGE, SKILLS, AND TRAINING

• Previous leadership/management experience
• Experience with Major Medical Insurance
• Pharmacy Technician License – required
• National Technician Certification – preferred
• Knowledge of pharmacy benefit, rejection codes, and claims processing
• Knowledge of pharmacy and insurance terminology of coverage
• Knowledge of HCPCs codes
• Able to multitask and work in a fast-paced/changing environment
• Detail-oriented
• Excellent verbal and written communication skills
• Ability to work with a diverse group of employees
• Ability to work in a collaborative manner

EMPLOYEE BENEFITS

We offer a comprehensive benefits package designed to support your health, financial security, and overall well-being:

• Medical Coverage, Dental, and Vision Coverage
• 401(k) with employer match
• Accident and Critical Illness coverage
• Company-paid life insurance options
• Generous PTO, paid holidays, and floating holidays
• Tuition reimbursement program.

Equal Employment Opportunity

Orsini Rare Disease Pharmacy Solutions is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or present or past disability (unless the nature and extent of the disability precludes performance of the essential functions of the job with or without a reasonable accommodation) in accordance with local, state and federal laws.

Americans with Disabilities Act

Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.

E-Verify Participation Notice

We participate in the federal E-Verify program to confirm the identity and employment eligibility of all newly hired employees.

All offers of employment are contingent upon the successful completion of Form I-9 and verification through the E-Verify system.

For more information about E-Verify, please review the official notices below:

E-Verify Participation Poster (English & Spanish):

https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf

Right to Work Poster (English & Spanish):

https://www.e-verify.gov/sites/default/files/everify/posters/IER_RightToWorkPoster.pdf