Reimbursement Program Lead – Patient Access & QA

Valeris, Inc.; United States; On-site; USD 60,000 - 95,000; Full time

Job summary

Valeris, Inc. is seeking a Program Supervisor to oversee reimbursement and administrative operations within the department. The role requires coaching staff, planning daily activities, and ensuring adherence to program guidelines.

You will liaise with the Program Manager, prepare reports, and advocate for patients regarding insurance coverage and access to complex pharmaceuticals, while coordinating with healthcare professionals to optimize outcomes.

Qualifications

• Bachelor’s degree and 2 years reimbursement/insurance, healthcare billing, or related experience; or a High School diploma with 4 years of reimbursement/insurance experience.
• 3-5 years supervisory experience preferred in a service-driven environment.
• Extensive knowledge of pharmacy benefit methodologies and Medicare/Medicaid/private payer payment methods.

Responsibilities

• Coach and mentor subordinates; conduct performance appraisals and schedule adherence.
• Liaison between Program Manager and Team; plan daily schedules and assign tasks.
• Submit daily/weekly productivity reports; monitor program needs and identify improvements.
• Advocate for patients and providers on insurance coverage and access for complex pharmaceuticals.
• Coordinate with inter-departmental stakeholders; manage escalations and QA activities.

Skills

Supervisory experience

Communication skills

Problem solving

Organizational skills

Attention to details

Team leadership

Patient advocacy

Education

Bachelor’s degree

High School diploma with 4 years experience

Experience in reimbursement/insurance

Job description

Valeris, Inc. is seeking a Program Supervisor to oversee reimbursement and administrative operations within the department. The role requires coaching staff, planning daily activities, and ensuring adherence to program guidelines.

You will liaise with the Program Manager, prepare reports, and advocate for patients regarding insurance coverage and access to complex pharmaceuticals, while coordinating with healthcare professionals to optimize outcomes.