Program Supervisor, Market Access Hub Operations
TrialCard - Morrisville, NC
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Mercalis is an integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Backed by proven industry expertise and results-driven technology,Mercalis helps navigate the complex life sciences marketplace by providing commercialization solutions to accelerate value and enhance patient lives.Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success while fostering a team environment. We are a diversity-driven organization with an inclusive approach to delivering patient-centric solutions that, eliminate barriers for patients, and increase patient access to life altering medications.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.Responsible for performance management including but not limited to, coaching and mentoring subordinates, employee counseling, employee performance appraisals, conflict resolution and schedule adherenceLiaison between Program Manager and TeamKeeps the Program Manager abreast on all aspects concerning the ProgramPlans daily schedule, assigns tasks and ensures daily goals are metSubmits daily and weekly reports to the Program Manager regarding productivity statistics at both the team and employee levelProvides organization and direction for daily reimbursement support according to the scope of services provided in the statement of workEvaluate and monitor Program needs, identifies unmet needs and provides recommendations for internal process improvement and workflow efficiencyFollows program guidelines and assists with the implementation of process improvementsServes as an advocate to patients and healthcare professionals regarding insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticalsAbility to perform thorough insurance benefit investigations, communicate insurance coverage to patients and providers, guide and follow up on prior authorizations, and assist with appeal processesProvides counsel and strategies on coverage and reimbursement issues to patients and healthcare providers, and works on patients’ behalf to identify and assess reimbursement coverage optionsEstablishes 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 auditsCommunicates and coordinates with inter-departmental stakeholders to resolve program specific escalations, conflicts and/or questionsProblem solves issues with autonomy and serves as first line of escalation for complex reimbursement issuesRoutinely conducts quality assurance activities through reviews, meetings, reports, observation of results, according to standard operating procedures, program specific procedures and regulatory complianceIdentify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events)Participates in and conducts meetings, as necessaryResponsible 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 dataEnsure all SOPs are followed with consistencyConducts miscellaneous tasks or projects as assignedBachelor’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 environmentExtensive knowledge of pharmacy benefit methodologiesExtensive knowledge of Medicare, Medicaid, and private payer payment methodologiesInitiative and strong work ethic criticalAbility to lead within a fluid and dynamic environmentExcellent problem-solving and decision-making skills requiredAttention to detailsStrong organizational and communication skills
Created: 2024-10-10