Area Manager – Healthcare Reimbursement Operations

the Opportunity•Bethesda, MD

30d•Remote

About The Position

We are seeking an experienced Area Manager to lead a remote healthcare reimbursement operations team supporting a large-scale annual benefits reverification program. This is a highly visible leadership role responsible for overseeing supervisors, team leads, and reimbursement professionals while ensuring productivity, quality, customer service, and service-level expectations are consistently achieved. The ideal candidate has a strong background in healthcare reimbursement, benefits verification/investigation, patient access, specialty pharmacy, pharmaceutical hub services, or patient assistance programs, along with proven experience managing teams in a fast-paced environment.

Requirements

4+ years of supervisory or management experience within healthcare reimbursement, medical insurance, specialty pharmacy, pharmaceutical hub services, patient access, patient assistance, or a related healthcare environment.
Demonstrated experience managing and developing teams; remote workforce leadership experience strongly preferred.
Strong knowledge of benefits verification/investigation and healthcare reimbursement processes.
Understanding of medical insurance terminology, billing and coding, payer requirements, appeals, and reimbursement challenges.
Knowledge of commercial insurance, Medicare, and Medicaid structures and reimbursement processes.
Ability to analyze productivity and quality metrics and translate data into actionable performance improvements.
Strong leadership, coaching, communication, and problem-solving skills.
Ability to manage multiple priorities and changing business requirements in a deadline-driven environment.
Strong presentation and interpersonal skills with the ability to communicate effectively with employees, leadership, and external stakeholders.
Proficiency with Microsoft Excel, Word, and PowerPoint and ability to quickly learn new systems.
Working knowledge of HIPAA and patient privacy requirements.

Nice To Haves

Experience working in high-volume healthcare operations, contact centers, reimbursement hubs, or insurance support environments preferred.
Candidates with leadership experience in one or more of the following environments are especially encouraged to apply: Pharmaceutical Hub Services | Specialty Pharmacy | Patient Access | Benefits Verification | Benefits Investigation | Reimbursement Services | Patient Assistance Programs | Financial Assistance Programs | Prior Authorization | Healthcare Contact Centers | Medical Insurance Operations

Responsibilities

Lead the day-to-day operations of a large remote healthcare reimbursement team.
Manage and coach Supervisors and Team Leads responsible for seasonal reimbursement and benefits verification staff.
Ensure teams meet established productivity, quality, customer service, and SLA expectations.
Partner with senior leadership on staffing, training, workforce planning, and operational execution for annual benefit reverification initiatives.
Support recruiting and onboarding efforts to ensure appropriate staffing levels for seasonal program demands.
Monitor daily and weekly performance metrics and provide reporting around key performance indicators.
Participate in daily production huddles, leadership meetings, training sessions, and program reviews.
Identify performance trends and work with leadership teams to implement coaching, process improvements, and corrective actions.
Assist with escalated benefit investigations, reimbursement challenges, payer issues, billing questions, and appeals.
Provide guidance regarding private insurance, Medicare, Medicaid, and pharmaceutical reimbursement processes.
Ensure operational activities follow established procedures, quality standards, and patient privacy requirements.
Assist with developing and improving SOPs related to reimbursement operations, benefits investigations, hiring, training, and quality.
Resolve complex operational and employee-related challenges with minimal supervision.
Collaborate across operations, recruiting, training, client services, and senior leadership to ensure successful program delivery.