Qureos Mentor

Mercalis

<div>Overview:
<div>
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.</div><div></div><div><br>
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.</div><div></div><div><br>
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.</div>
Responsibilities:
<ul><li>Responsible for performance management including but not limited to, coaching and mentoring subordinates, employee counseling, employee performance appraisals, conflict resolution and schedule adherence</li><li>
Liaison between Program Manager and Team</li><li>
Keeps the Program Manager abreast on all aspects concerning the Program</li><li>
Plans daily schedule, assigns tasks and ensures daily goals are met</li><li>
Submits daily and weekly reports to the Program Manager regarding productivity statistics at both the team and employee level</li><li>
Provides organization and direction for daily reimbursement support according to the scope of services provided in the statement of work</li><li>
Evaluate and monitor Program needs, identifies unmet needs and provides recommendations for internal process improvement and workflow efficiency</li><li>
Follows program guidelines and assists with the implementation of process improvements</li><li>
Serves as an advocate to patients and healthcare professionals regarding insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals</li><li>
Ability to perform thorough insurance benefit investigations, communicate insurance coverage to patients and providers, guide and follow up on prior authorizations, and assist with appeal processes</li><li>
Provides counsel and strategies on coverage and reimbursement issues to patients and healthcare providers, and works on patients&rsquo; behalf to identify and assess reimbursement coverage options</li><li>
Establishes 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)</li><li>
Preparation of and participation in client audits</li><li>
Communicates and coordinates with inter-departmental stakeholders to resolve program specific escalations, conflicts and/or questions</li><li>
Problem solves issues with autonomy and serves as first line of escalation for complex reimbursement issues</li><li>
Routinely conducts quality assurance activities through reviews, meetings, reports, observation of results, according to standard operating procedures, program specific procedures and regulatory compliance</li><li>
Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events)</li><li>
Participates in and conducts meetings, as necessary</li><li>
Responsible for performance management including but not limited to, coaching and mentoring subordinates, employee counseling, employee performance appraisals, conflict resolution and schedule adherence.
</li><li>On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data</li><li>
Ensure all SOPs are followed with consistency</li><li>
Conducts miscellaneous tasks or projects as assigned</li></ul>
Qualifications:
<ul><li>Bachelor&rsquo;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
</li><li>3-5 years supervisory experience preferred with progressive levels of responsibility within a service driven environment</li><li>
Extensive knowledge of pharmacy benefit methodologies</li><li>
Extensive knowledge of Medicare, Medicaid, and private payer payment methodologies</li><li>
Initiative and strong work ethic critical</li><li>
Ability to lead within a fluid and dynamic environment</li><li>
Excellent problem-solving and decision-making skills required</li><li>
Attention to details</li><li>
Strong organizational and communication skills</li></ul></div>

Program Supervisor

<div>Overview:
<div>
The Program Manager (PM), as the primary business relationship manager, is responsible for program management, account management, financial management and business analysis.</div><div></div><div><br>
The PM will be responsible for providing excellent customer service, exceptional program management, in-depth program knowledge and operational excellence for their assigned brands. As the primary point of contact between our valued customers and Mercalis, the PM serves a crucial role in driving internal project teams to deliver Mercalis&rsquo;s full suite of products and services on schedule, on budget, and within scope.</div><div></div><div><br>
The ideal candidate must be a self-starter, high performer and able to embrace change in order to adapt within a fast growing organization.</div>
Responsibilities:
<div>
The ideal candidate must be a self-starter, high performer and able to embrace change in order to adapt within a fast growing organization.</div><br>
<div></div><ul><li>
Manage client contracts / statements of work and execute accordingly, host and facilitate internal and client kick-off calls</li><li>
Make recommendations to program strategies and roadmap offering the best solution for client projects in accordance with the SOW and in collaboration with the Director of Client Services</li><li>
Gather and document business requirements and communicate changes, enhancements, and modifications &ndash; verbally or written &ndash; to clients, internal functional areas, sponsors, and other stakeholders so that business requirements and solutions are understood</li><li>
Manage the program budget for the client and provide recommendations for effectively managing program cost</li><li>
Interface with clients and maintain business essential relationships on a day-to-day basis as the primary business relationship manager</li><li>
Conduct regular meetings (phone, webex, onsite) to update the client on program status, deliver presentations and provide an avenue for program enhancements</li><li>
Become an expert on the therapeutic class of assigned brands and possess a robust understanding of competitive products utilized within the therapeutic class</li><li>
Based on brands strategy, objectives and competitive landscape, be able to develop and implement innovative solutions for clients to maximize brand value and competitive positioning</li><li>
Measure, and monitor program key performance indicators to develop data-driven recommendations</li><li>
Learn and assist the client in navigating client-internal requirements and processes specific to their organization</li><li>
Be well-versed on their third party service vendor landscape in order to manage and coordinate client vendor relationships (agencies, SPPs, HUBs, service providers, data/analytics teams)</li><li>
Build and maintain healthy relationships with all internal functional areas, and take a leadership role with all internal project</li><li>
stakeholders</li><li>
Be a sought out resource within Mercalis as both an internal and external subject matter expert</li><li>
Provide mentorship and training to Associate Program Managers where needed</li></ul>
Qualifications:
<ul><li>Bachelor&rsquo;s degree with a concentration in business, accounting, marketing and/or healthcare, or pharmaceutical industry, graduate degree and/or additional certifications including PMP preferred</li><li>
Three to Four (3-4) years of project or program management experience</li><li>
If an internal applicate, seeking extensive experience with Mercalis systems and services (preferred)</li><li>
Exceptional communication skills, including verbal and written, ability to interact with internal and external stakeholders</li><li>
Able to multi-task in a fast paced environment while functioning as a member of a highly collaborative team</li><li>
Highly proficient in Microsoft Office (Project, Excel, PowerPoint, Visio, Word, Access, OneNote)</li><li>
Organized and detail-oriented with effective time management skills</li><li>
Budget management and/or financial accounting skills</li><li>
Ability to take initiative and anticipate needs</li><li>
Ability to travel both locally and out-of-town, expectation is up to 10% travel</li></ul><div></div><div><b><br>
Why work for Mercalis?</b></div><ul><li>
Diversity, Equity, Inclusion &amp; Belonging are paramount to our culture and success. Our dedication to DEI is both organic and intentional</li><li>
Our Mission is rewarding and fulfilling (Patient Access to Life-Saving/Improving/Extending Medications/Treatments)</li><li>
We employ the best Talent and Tools from the Patient Access Industry (We are the Industry Leader)</li><li>
We monitor the market to ensure we offer competitive salaries and benefits.</li><li>
401K w/ 5% matching; day-1 vestment period</li><li>
15 days PTO</li><li>
8 Holidays + 2 Floating Days</li><li>
Health/Dental/Vision/Life; Coverage Day-1</li><li>
Gym Reimbursement</li><li>
Volunteer Hours</li></ul><ul><li><i>This is not an exhaustive list of benefits.</i></li><li><i>Benefits are subject to change.</i></li></ul><div><i>
** Some positions require onsite presence and/or structured hours/shifts.</i></div></div>

Program Manager, Client Services

<div>Overview:
<p><b>
*** THE SHIFTS FOR THESE ROLE WILL BE M-F 10A-7P OR 11A-8P EST ONLY ***</b></p><p></p><p><br>
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris&trade; revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.</p><p></p><div><br>
The Patient Navigator plays a critical role in ensuring patients have access to life-altering medications by supporting them through complex processes such as insurance verification, prior authorizations, and appeals. This position combines exceptional customer service, relationship management, and expertise in reimbursement practices to provide personalized support and ensure compliance with all healthcare regulations. The role also focuses on educating healthcare providers and patients on access, coverage, and reimbursement support. These roles will be regionally aligned to best support patients.</div>
Responsibilities:
<ul><li>Serves as the single point of contact and provides personalized case management for patients, caregivers, and healthcare providers (HCPs), including delivery of benefit investigations, prior authorization tracking, and appeal support.</li><li>
Educate patients, HCPs, and stakeholders on access and reimbursement processes, payer policies, and Mercalis programs (e.g., patient assistance programs, copay programs).</li><li>
Build and maintain trusted relationships with patients, prescribers, and client stakeholders by delivering accurate, timely, and compassionate support.</li><li>
Coordinate and collaborate with client field teams, following agreed upon business rules and guidelines</li><li>
Communicate benefit coverage options and next steps in the patient journey using clear and patient-friendly language.</li><li>
Leverage electronic tools to navigate and complete benefit investigations, ensuring payer coverage is secured for prescribed treatments.</li><li>
Ensure all activities comply with healthcare laws, regulations, and Mercalis standard operating procedures (e.g., HIPAA, insurance guidelines).</li><li>
Identify and escalate adverse events, product complaints, and special situation reports as required by the program.</li><li>
Document all activities in the Mercalis system, maintaining detailed and accurate records.</li><li>
Support adherence services, including patient education and coordinating nurse teaching as applicable.</li><li>
Participate in team meetings and ongoing training to stay updated on policies and procedures.</li><li>
Utilize Valeris&rsquo; values as the driving force behind the team&rsquo;s success</li><li>
On time adherence to training deadlines for all corporate policies and procedures</li><li>
Ensure all SOPs are followed with consistency</li><li>
Perform additional tasks or projects as assigned</li></ul>
Qualifications:
<ul><li>Completion of Bachelor's degree (or higher) required.</li><li>
A degree in healthcare administration, social science or similar related fields is strongly preferred.</li><li>
Minimum two (2) years of experience in healthcare access delivery or management is strongly preferred.</li><li>
five (5) to ten (10) years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education experience will be considered in lieu of degree.</li><li>
Other certifications and five (5) or more consecutive years of experience in relevant field could be considered. Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist) or CCM in healthcare or social science (Certified Case Manager).</li><li>
Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.</li><li>
Ability to prioritize tasks and work efficiently in a fast-paced environment.</li><li>
Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.</li><li>
Bilingual / Multilingual is a plus.</li></ul><div></div><p><b><br>
Physical Demands &amp; Work Environment</b></p><ul><li>
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.</li><li>
Although very minimal, flexibility to travel as needed is preferred.</li><li>
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.</li></ul><p></p><p><b><br>
Why Work for Valeris?</b></p><p>
We&rsquo;re committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:</p><ul><li>
Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs</li><li>
Additional health support, including telehealth and Employee Assistance Program (EAP) services</li><li>
Company match on Health Savings Account contributions</li><li>
Free Basic Life and AD&amp;D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000</li><li>
Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability</li><li>
401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting</li><li>
Paid Time Off (PTO) and Sick Leave to support work-life balance</li><li>
Team members receive nine paid holidays plus two floating holidays</li><li>
Opportunities for advancement in a company that supports personal and professional growth</li><li>
A challenging, stimulating work environment that encourages new ideas</li><li>
Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace</li><li>
A mission-driven, inclusive culture where your work makes a meaningful impact</li></ul><p></p><p><br>
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.</p><p></p><p><b><br>
Our Commitment to Equal Opportunity</b></p><div>
At Valeris, we don&rsquo;t just accept difference &ndash; we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.</div></div>

Patient Navigator

Join Mercalis and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Mercalis

About Company

Program Supervisor

Program Manager, Client Services

Patient Navigator