**SHIFT AVAILABLE FOR THIS ROLE IS 11AM-8PM EST M-F**

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.

• Provide direct leadership, coaching, and mentoring to team members, including intake coordinators, reimbursement case managers, and other program staff. Responsibilities include employee counseling, performance appraisals, conflict resolution, and ensuring schedule adherence.

• Serve as the liaison between the Program Manager and the team, keeping leadership abreast of all aspects concerning program performance, trends, and escalations.

• Plan daily schedules, assign tasks, and monitor team productivity to ensure daily, weekly, and contractual goals are met.

• Submit daily and weekly reports to the Program Manager with detailed productivity statistics at both the team and individual levels.

• Provide organization and direction for daily reimbursement support activities according to the scope of services outlined in the statement of work.

• Evaluate program needs, identify unmet needs, and recommend internal process improvements and workflow efficiencies.

• Support implementation of new or updated program guidelines, ensuring team compliance with SOPs, regulatory requirements, and contractual obligations.

• Act as an advocate for patients and healthcare professionals regarding insurance coverage, medical billing, reimbursement processes, and access to complex pharmaceuticals.

• Perform or oversee comprehensive benefit investigations, prior authorization guidance, appeals support, and communication of coverage details to patients and providers.

• Counsel patients and healthcare providers on complex coverage and reimbursement issues and work to identify and assess reimbursement coverage options.

• Establish and maintain trusted relationships with patients, providers, clients, and field reimbursement managers. Serve as a program liaison for regional and client-facing inquiries.

• Coordinate with offshore intake coordinators and reimbursement case managers to ensure alignment, workload distribution, and seamless program execution.

• Participate in quarterly business reviews (QBRs) with clients; while presentation is not required, active participation and presence are expected to support program discussions.

• Assist with onboarding, training, and development of new team members to ensure operational readiness and program compliance.

• Ensure scheduling aligns with staffing needs, program volumes, and contractual expectations.

• Lead problem-solving and serve as the first line of escalation for complex reimbursement issues, working independently to resolve conflicts and barriers to patient access.

• Conduct routine quality assurance activities through case reviews, meetings, reporting, and observation to ensure adherence to program standards and regulatory compliance.

• Participate in internal and external meetings, client audits, and cross-functional collaborations as needed.

• Contribute to strategic program planning by identifying trends, recommending process improvements, and providing insights to strengthen patient access and overall program success.

• Perform other responsibilities as assigned in alignment with program and organizational needs.

• 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
• 3-5 years supervisory experience preferred with progressive levels of responsibility within a service driven environment
• Extensive knowledge of pharmacy benefit methodologies
• Extensive knowledge of Medicare, Medicaid, and private payer payment methodologies
• Initiative and strong work ethic critical
• Ability to lead within a fluid and dynamic environment
• Excellent problem-solving and decision-making skills required
• Attention to details
• Strong organizational and communication skills