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Program Supervisor

2 months ago

Morrisville North Carolina, United States Mercalis Full time
About Mercalis

Mercalis is a leading integrated life sciences commercialization partner that provides comprehensive solutions to accelerate value and enhance patient lives.

Job Summary

We are seeking a highly skilled and experienced Program Supervisor to join our team. As a Program Supervisor, you will be responsible for reimbursement and administrative supervisory work in the coordination of program services, quality assurance, and personnel services within the department.

Key Responsibilities
  • Performance management, including coaching and mentoring subordinates, employee counseling, employee performance appraisals, conflict resolution, and schedule adherence.
  • Liaison between Program Manager and Team.
  • Keeps the Program Manager abreast on all aspects concerning the Program.
  • Plans daily schedule, assigns tasks, and ensures daily goals are met.
  • Submits daily and weekly reports to the Program Manager regarding productivity statistics at both the team and employee level.
  • Provides organization and direction for daily reimbursement support according to the scope of services provided in the statement of work.
  • Evaluate and monitor Program needs, identifies unmet needs, and provides recommendations for internal process improvement and workflow efficiency.
  • Follows program guidelines and assists with the implementation of process improvements.
  • Serves as an advocate to patients and healthcare professionals regarding insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals.
  • Ability to perform thorough insurance benefit investigations, communicate insurance coverage to patients and providers, guide and follow up on prior authorizations, and assist with appeal processes.
  • Provides counsel and strategies on coverage and reimbursement issues to patients and healthcare providers, and works on patients' behalf to identify and assess reimbursement coverage options.
  • Establishes relationships, develops trust, and maintains rapport with patients and healthcare providers; Acts as an assigned liaison to client contacts (e.g., regional contact for sales representatives).
  • Preparation of and participation in client audits.
  • Communicates and coordinates with inter-departmental stakeholders to resolve program specific escalations, conflicts, and/or questions.
  • Problem solves issues with autonomy and serves as first line of escalation for complex reimbursement issues.
  • Routinely conducts quality assurance activities through reviews, meetings, reports, observation of results, according to standard operating procedures, program specific procedures, and regulatory compliance.
  • Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events).
  • Participates in and conducts meetings, as necessary.
  • Responsible for performance management including but not limited to, coaching and mentoring subordinates, employee counseling, employee performance appraisals, conflict resolution, and schedule adherence.
  • On-time adherence to training deadlines for all corporate policies and procedures governing access to confidential data.
  • Ensure all SOPs are followed with consistency.
  • Conducts miscellaneous tasks or projects as assigned.
Requirements
  • Bachelor's degree and 2 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing preferred or in lieu of a degree, a High School diploma or equivalent with 4 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing.
  • 3-5 years supervisory experience preferred with progressive levels of responsibility within a service-driven environment.
  • Extensive knowledge of pharmacy benefit methodologies.
  • Extensive knowledge of Medicare, Medicaid, and private payer payment methodologies.
  • Initiative and strong work ethic critical.
  • Ability to lead within a fluid and dynamic environment.
  • Excellent problem-solving and decision-making skills required.
  • Attention to details.
  • Strong organizational and communication skills.
Why Work for Mercalis?

Mercalis is committed to diversity, equity, and inclusion. Our mission is to provide patient access to life-saving, improving, or extending medications and treatments. We employ the best talent and tools from the patient access industry and offer competitive salaries and benefits.

We offer a range of benefits, including:

  • 401K with 5% matching; day-1 vestment period.
  • 15 days PTO.
  • 8 Holidays + 2 Floating Days.
  • Health/Dental/Vision/Life; Coverage day-1.
  • Gym Reimbursement.
  • Volunteer Hours.
  • Flexibility/Hybrid/Remote.

Some positions require onsite presence and/or structured hours/shifts.