Supervisor - Medical Staff

Valeris; North Carolina; On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health plans

Telehealth availability

HSA option

401(k) match

Paid holidays

Career growth

Job summary

Valeris is seeking a Program Supervisor in a professional office setting focused on reimbursement and insurance processes for complex pharmaceuticals. The role coordinates reimbursement support, ensures adherence to policies, and mentors staff.

The position requires a Bachelor's degree (or HS with 4 years’ experience) and strong knowledge of Medicare/Medicaid, with travel as needed. Valeris offers comprehensive health plans, retirement options, and growth opportunities.

Qualifications

• Bachelor's degree and 2 years of reimbursement/insurance experience preferred.
• Extensive knowledge of Medicare, Medicaid, and private payer payment methodologies.

Responsibilities

• 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, identify unmet needs and provide recommendations for internal process improvement and workflow efficiency.
• Provides counsel and strategies on coverage and reimbursement issues to patients and healthcare providers, and works on patients' behalf to identify reimbursement coverage options.
• 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 SOPs and regulatory compliance.

Skills

Medicare knowledge

Reimbursement expertise

Patient advocacy

Coaching & mentoring

Education

Bachelor's degree

HS diploma + 4y exp

Job description

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.

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. Responsible for performance management including but not limited to, coaching and mentoring subordinates, employee counseling, employee performance appraisals, conflict resolution and schedule adherence.

• 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
• 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
• 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
• 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
• Conducts miscellaneous tasks or projects as assigned

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

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

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
• ~ 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
• ~ Team members receive nine paid holidays plus two floating holidays
• ~ Opportunities for advancement in a company that supports personal and professional growth
• ~ Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
• ~ 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.