Program Supervisor

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Oversee reimbursement and administrative tasks while coordinating program services, quality assurance, and personnel functions.

• Execute program policies and procedures in line with standard operating and program-specific protocols.

• Mentor and coach team members, conduct performance evaluations, manage conflicts, and track schedule compliance.

• Act as a liaison between the Program Manager and team, ensuring the manager is updated on program developments.

• Organize daily schedules, delegate tasks, and guarantee that daily objectives are achieved.

• Provide daily and weekly productivity reports at both team and individual levels.

• Lead daily reimbursement assistance in accordance with the statement of work.

• Assess program requirements and suggest enhancements for processes and workflows.

• Advocate for patients and healthcare professionals concerning insurance coverage, medical billing, reimbursement, and access to complex medications.

• Perform insurance benefit investigations, communicate coverage details, guide and follow up on prior authorizations, and assist with appeals.

• Advise patients and healthcare providers on coverage and reimbursement methods and alternatives.

• Cultivate relationships with patients, healthcare professionals, and client representatives.

• Prepare for and engage in client audits.

• Collaborate with inter-departmental stakeholders to address escalations, conflicts, and inquiries.

• Independently resolve complex reimbursement issues as the primary escalation point.

• Carry out quality assurance tasks in compliance with procedures and regulations.

• Identify and report pharmacovigilance data, including adverse events.

• Participate in and lead meetings.

• Ensure training deadlines and adherence to SOPs are met.

• Complete additional assigned projects or tasks.

⛳️ Requirements

• Bachelor’s degree with 2 years of experience in reimbursement/insurance, healthcare billing, physician office, or health insurance processing preferred; alternatively, a High School diploma or equivalent with 4 years of relevant experience.

• Preferred 3–5 years of supervisory experience with increasing responsibilities in a service-oriented environment.

• In-depth knowledge of pharmacy benefit methodologies.

• Comprehensive understanding of Medicare, Medicaid, and private payer payment systems.

• Strong initiative and work ethic.

• Capability to lead in a fast-paced and evolving environment.

• Excellent problem-solving and decision-making abilities.

• Keen attention to detail.

• Strong organizational and communication skills.

• Ability to type at least 35 words per minute with 97% accuracy preferred.

• Willingness to travel as needed preferred.

• Successful completion of a background check and, depending on the role, a drug screening.

🏝️ Benefits

• Medical, dental, and vision insurance plans, including HSA- and FSA-eligible options, with contributions from Valeris towards premium costs.

• Access to Telehealth and Employee Assistance Program (EAP) services.

• Company match for Health Savings Account contributions.

• Complimentary Basic Life and AD&D coverage equivalent to annual earnings, with a minimum of $50,000 and a maximum of $300,000.

• Company-funded Short-Term Disability coverage, with an option to purchase Long-Term Disability.

• 401(k) Retirement Savings Plan featuring a 100% match on the first 5% contributed, with immediate vesting.

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for career advancement and personal as well as professional development.

• Engaging and dynamic work environment that fosters innovative ideas.

• Inclusive workplace culture driven by a mission.

• Background check and, dependent on the position, drug screening in accordance with company standards.