Operations Support Coordinator (OSC)

The Operations Support Coordinator (OSC) plays a vital role in ensuring the accuracy, timeliness, and efficiency of key operational workflows that support member care. This position is responsible for managing essential administrative and clinical-adjacent functions such as medication prior authorizations, toxicology result entry, virtual direct observed testing oversight, clinical and operational scheduling, and program coordination for self-pay members.

The OSC ensures that all tasks are completed in accordance with organizational standards, regulatory requirements, and established timelines to promote a seamless care experience.

Essential Functions:

Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

• Responsible for preparing and submitting medication prior authorization requests and renewals.
• Investigate and resolve payer responses; communicate outcomes to appropriate teams; document actions in the EMR.
• Coordinate administrative duties such as prescription creation, attendance, payment collection, etc., as part of the Safety Net Program, and ensure program protocols are followed.
• Monitor and ensure procedural compliance for virtual Direct Observed Toxicology collections via oral swabs, troubleshooting and escalating issues as they arise.
• Responsible for accurate and timely entry of  toxicology results, including confirmatory and state-specific (e.g., Kentucky) results.
• Collaborate with field clinical & operational teams to investigate and resolve workflow or data discrepancies.
• Maintain accurate medication records and compliance by processing prescription cancellations as needed.
• Ensure Accuracy in Data Management.
• Audit and maintain  member information within the EMR system to ensure data integrity  and compliance.
• Identify and communicate process improvement initiatives to enhance member care.
• Provide flexible and responsive support to Care Teams with additional administrative duties as assigned.
• Support clinical and operational scheduling, including staff and group coverage assignments.
• Provide timely, professional communication to internal teams, members, and external partners. 

Other Duties and Responsibilities:

• Other duties as assigned.

Knowledge, Skills and Abilities:

• Fluency with Google Suite (Sheets, Docs, Meet, Drive, etc.) and Microsoft Office applications 
• Familiarity with electronic medical records (EMR) systems
• Ability to troubleshoot minor technological challenges and learn new software systems or processes as needed.
• Exceptional accuracy in data entry while maintaining productivity. 
• Strong ability to prioritize tasks and manage complex administrative duties with attention to detail while meeting deadlines with little supervision.
• Ability to manage confidential and highly sensitive information in compliance with HIPAA and 42 CFR Part 2 guidelines.
• Ability to troubleshoot issues, identify solutions, appropriately escalate concerns, and adapt to new challenges effectively.
• Ability to work independently and as part of a team to achieve shared goals and maintain operational efficiency.
• Exceptional verbal and written communication skills, including the ability to effectively communicate data-related issues and solutions to team members or supervisors.
• Willingness to work evenings as needed to provide appropriate member care.

Qualifications & Requirements:

• High school diploma or equivalent required
• Associate’s degree preferred, or 2+ years of relevant experience
• At least 1-2 years of experience in healthcare administration or a similar administrative role.
• For remote roles, access to reliable internet and telephone services, specifically 50M download and 10M upload packages or higher as well as a strong WiFi signal from your remote work location.
• Must meet pre-employment requirements and maintain all applicable state and job-related guidelines for background screening.  Depending on state-specific requirements, this may include fingerprinting, drug testing, health screening, CPR/Basic First Aid, and license/credential verifications.