Program Supervisor

3 weeks ago


Morrisville North Carolina, United States Mercalis Full time
Overview:
 

Remote Role

3-4 weeks of Training Onsite (Located near RDU Airport)

 

Mercalis is an integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Backed by proven industry expertise and results-driven technology, Mercalis helps navigate the complex life sciences marketplace and provides commercialization solutions to accelerate value and enhance patient lives.

 

Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success while fostering a team environment. We are a diversity-driven organization with an inclusive approach to delivering patient-centric solutions that eliminate barriers for patients, increase access to medications, and help patients receive life-saving treatments.

 

As a Program Supervisor, you will join our team on a journey to help eliminate barriers for patients, increase their access to medications, and help them receive lifesaving treatments while working in an environment that nurtures you.

 

The Program Supervisor is responsible for reimbursement and administrative supervisory work in the coordination of program services, quality assurance and personnel services within the department. Work involves the identification and implementation of program policies and procedures as directed by standard operating and program specific procedures. Work is performed with latitude for independent judgment, and action is reviewed by the Program Manager through conferences, reports, and observation of results obtained.

Responsibilities:
Responsible for performance management including but not limited to, 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 complex 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

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

Other responsibilities, as assigned

Qualifications:
Bachelor’s degree and 4 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 5 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing  

3-5 years supervisory experience with progressive levels of responsibility within a service driven environment

Extensive knowledge of pharmacy benefit methodologies for pharmaceuticals

Extensive knowledge of Medicare, Medicaid, and private payer payment methodologies

Impeccable communication skills

Initiative and strong work ethic critical

Confident in supervising a team professionally, consistently and fairly

Ability to lead within a fluid and dynamic environment

Ability to multitask and prioritize in a fast-paced environment

Excellent problem-solving and decision-making skills required

Attention to details

Strong organizational skills

 

Why Work for Mercalis?

Diversity, Equity, and Inclusion is paramount to our culture and success. Our dedication to DE&I is both organic and intentional.

Our Mission is rewarding and fulfilling (Patient Access to Life-Saving/Improving/Extending Medications/Treatments)

We employ the best Talent and Tools from the Patient Access Industry (We are the Industry Leader)

We monitor the market to ensure we offer competitive salaries and benefits. 

401K w/ 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

 

*This is not an exhaustive list of benefits.  

*Benefits are subject to change 

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

 

 #LI-ML1


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