Reimbursement & Medical Benefits Operations Supervisor

McKesson•Cary, NC

12d•Hybrid

About The Position

The Supervisor, CGT Reimbursement & Medical Benefit Operations leads a team supporting Cell and Gene Therapy reimbursement, medical benefit investigations, provider billing support, and broader Biologics medical benefit operations. The role serves as a reimbursement verification and medical billing subject matter expert while supervising, coaching, managing performance, and developing reimbursement professionals. This is a hybrid role for candidates who live within drivable distance of McKesson’s Ft. Worth, Texas, or Cary, North Carolina, locations. The posting gives target compensation of $71,000–$73,000 annually, along with a 5% bonus; it also lists a base pay range of $59,200–$98,600. The position requires 20% travel.

Requirements

Typically requires 3 or more years of subject matter experience, including demonstrated leadership capabilities.
3 or more years of experience in specialty pharmacy, medical benefit reimbursement, provider billing, revenue cycle, or hospital reimbursement.
People leadership or supervisory experience.
Demonstrated medical benefit and billing experience.
Experience in the specialty healthcare or pharmaceutical segment, with understanding of the healthcare continuum and relationships among manufacturers, patients, providers, and payers.
Strong understanding of health insurance coverage and reimbursement processes, including medical coding and billing practices.
Knowledge of payer policy interpretation, coding, claims adjudication, and reimbursement methodologies.
Strong analytical, communication, and cross-functional collaboration skills.
Knowledge of applicable healthcare laws and regulations, including HIPAA, Medicare, and Medicaid guidelines.
Ability to communicate effectively with patients, healthcare providers, and insurance companies and to build credible relationships across multiple business units.
Ability to work effectively in a team-oriented environment and collaborate toward shared goals.
Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint.
Strong prioritization, time management, and project management skills.
Ability to manage complex issues, work independently, demonstrate flexibility, and work effectively with remote internal and external teams.
Knowledge of LOAs, SCAs, payer/provider contracting implications, and treatment site reimbursement.
Experience supporting accounts receivable, denial prevention, and reimbursement optimization.
Critical thinking, analytical, research, and problem-solving skills.
Willingness to travel 20%.

Nice To Haves

Bachelor’s degree preferred in healthcare, business, finance, nursing, or a related discipline.
Familiarity with cell and gene therapies and the associated reimbursement landscape.
Experience specifically related to cell and gene therapies is highly desirable.

Responsibilities

Lead, coach, mentor, and develop a team of reimbursement and medical benefit specialists.
Conduct performance reviews, succession planning, employee development, and workforce planning.
Oversee medical benefit investigations, prior authorizations, reimbursement support, and complex payer escalations.
Partner with internal medical billing teams to ensure claims are billed accurately and compliantly.
Consult with Contracting teams regarding LOAs and SCAs to support reimbursement and operational requirements.
Support Accounts Receivable teams with denial management, underpayments, payer disputes, and reimbursement resolution.
Serve as the reimbursement subject matter expert for Cell and Gene Therapy and broader Biologics medical benefit programs.
Lead process improvement initiatives and launch readiness activities for new therapies.