Program Supervisor

Valeris; United States; Remote; USD 65.000 - 90.000; Vollzeit

Benefits dieser Stelle

Medical, dental, and vision plans

401(k) with company match

Paid time off

Holiday and sick leave

Zusammenfassung

Valeris is seeking a Program Supervisor to lead reimbursement and administrative coordination within our healthcare services division. You will manage a team, ensure program adherence, and drive process improvements to enhance patient access to complex medications.

The role requires strong knowledge of pharmacy benefit methodologies, Medicare/Medicaid, and private payer payments, plus experience in healthcare billing and staff supervision.

Qualifikationen

• 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

Aufgaben

• Coach and mentor subordinates; conduct employee performance appraisals and scheduling adherence
• Serve as liaison between Program Manager and team
• Direct daily reimbursement support and productivity reporting
• Ensure adherence to SOPs and program guidelines; improve workflows
• Advocate for patients and providers on insurance coverage and reimbursements
• Coordinate audits and inter-departmental escalations
• Provide orientation to training deadlines and policy compliance

Kenntnisse

Supervisory experience

Healthcare billing

Pharmacy benefit knowledge

Communication skills

Ausbildung

Bachelor's degree

High School diploma with 4 years reimbursement/insurance experience

Jobbeschreibung

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.

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 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 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

QUALIFICATIONS :

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

Physical Demands & Work Environment

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
• Although very minimal, flexibility to travel as needed is preferred.
• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.

Why Work for Valeris?

We’re committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
• Additional health support, including telehealth and Employee Assistance Program (EAP) services
• Company match on Health Savings Account contributions
• Free Basic Life and AD&D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000
• Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
• 401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting
• Paid Time Off (PTO) and Sick Leave to support work-life balance
• Team members receive nine paid holidays plus two floating holidays
• Opportunities for advancement in a company that supports personal and professional growth
• A challenging, stimulating work environment that encourages new ideas
• Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
• A mission-driven, inclusive culture where your work makes a meaningful impact

Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.

Our Commitment to Equal Opportunity

At Valeris, we don’t just accept difference - we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.