Reimbursement & Medical Benefits Operations Supervisor

McKesson•Cary, NC

13d•$59,200 - $98,600•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 subject matter expert in reimbursement verification and medical billing while directly supervising, coaching, managing performance, and developing reimbursement professionals. This is a hybrid role. Candidates must live within drivable distance of McKesson's Ft. Worth, Texas, or Cary, North Carolina, locations. The target compensation is $71,000–$73,000 annually, along with a 5% bonus. The posted base pay range is $59,200–$98,600 annually.

Requirements

Typically requires 3+ years of subject matter experience, including demonstrated leadership capabilities.
3+ years of specialty pharmacy, medical benefit reimbursement, provider billing, revenue cycle, or hospital reimbursement experience.
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 the 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.
Exceptional written and verbal communication skills, collaboration skills, and ability to influence others and build credible relationships across business units.
Ability to communicate effectively with patients, healthcare providers, and insurance companies.
Ability to work effectively in a team-oriented environment and collaborate to achieve common goals.
Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint.
Strong prioritization, time management, and project management skills.
Ability to manage complex issues, function 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 A/R, denial prevention, and reimbursement optimization.
Critical thinking, analytical, research, and problem-solving skills.

Nice To Haves

Bachelor's degree in healthcare, business, finance, nursing, or a related discipline is preferred.
Familiarity with cell and gene therapies and the associated reimbursement landscape is a plus; 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 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.