Program Supervisor – Hub

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

📋 Description

• Oversee reimbursement and administrative program services, quality assurance, and personnel services.

• Mentor and guide subordinates, perform counseling and performance evaluations, resolve conflicts, and monitor schedule compliance.

• Serve as the liaison between the Program Manager and the team.

• Keep the Program Manager updated on program activities.

• Organize daily schedules, allocate tasks, and ensure that daily objectives are achieved.

• Submit daily and weekly productivity reports on both team and individual levels.

• Organize and manage daily reimbursement support in line with the statement of work.

• Assess program requirements, identify deficiencies, and suggest enhancements to processes and workflows.

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

• Conduct investigations into insurance benefits, communicate coverage details, guide and follow up on prior authorizations, and assist with appeals.

• Counsel patients and healthcare providers on coverage and reimbursement strategies.

• Build and maintain relationships with patients, healthcare providers, and client contacts.

• Prepare for and engage in client audits.

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

• Independently resolve issues and act as the first-line escalation point for complex reimbursement challenges.

• Execute quality assurance activities following SOPs, program procedures, and regulatory standards.

• Identify and report pharmacovigilance information, including adverse events, as necessary.

• Participate in and lead meetings.

• Ensure adherence to corporate policies, SOPs, training deadlines, and program guidelines consistently.

• Carry out additional assigned tasks or projects.

⛳️ Requirements

• A 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 levels of responsibility in a service-oriented environment.

• In-depth knowledge of pharmacy benefit methodologies.

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

• Strong initiative and work ethic.

• Ability to lead in a dynamic and evolving environment.

• Excellent problem-solving and decision-making abilities.

• High attention to detail.

• Strong organizational and communication skills.

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

• Willingness to travel as necessary preferred.

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

🏝️ Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing to premium costs.

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

• Company matching contributions on Health Savings Account deposits.

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

• Company-sponsored 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 advancement and personal and professional development.

• An engaging and stimulating work environment that fosters new ideas.

• An inclusive workplace with a mission-driven culture.

• Background check and, depending on the position, drug screen in accordance with company standards.