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Patient Navigator
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, Valerisâ„¢ 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.
Key Responsibilities:
- Build and maintain trusted relationships with patients by demonstrating proactive communication, delivering timely and accurate services, and showing a strong commitment to patient well-being.
- Ensure all interactions and relationship management practices comply with relevant healthcare laws and regulations.
- Demonstrate prior experience working with pharmacy benefit products and patients, or in immunology practices, to better understand patient needs and concerns.
- Conduct program welcome calls to patients, engaging them effectively and explaining available services and resources for their support.
- Utilize motivational interviewing techniques to actively involve patients in goal setting and achieving their healthcare objectives.
- Perform post Benefits Investigation calls to patients, clearly explaining coverage options to enhance patient understanding.
- Effectively handle all client inquiries that cannot be resolved through standard reporting processes.
- Address patient inquiries in accordance with applicable business rules, providing accurate and helpful information.
- Articulate complex reimbursement and billing information in a clear and concise manner to ensure patients comprehend their coverage benefits and financial responsibilities.
- Handle inbound calls as per the program-approved Frequently Asked Questions (FAQs).
- Exhibit excellent customer service skills, even in a fast-paced environment, and de-escalate any challenging situations in a professional and appropriate manner.
- Triage patients to appropriate internal or external resources, depending on their needs and requirements.
- Ensure proper documentation and recording of patient enrollment into the program, following established business rules.
- Provide patients with comprehensive information and education about products, including the course of treatment, insurance coverage benefits, anticipated out-of-pocket costs, potential financial assistance resources, and ongoing treatment support.
- Proactively manage assigned cases and tasks to maintain service levels and deliver excellent customer service to patients.
- Empower and inspire patients to take charge of their therapy plan as prescribed by their healthcare provider.
- Leverage electronic tools to identify benefits and payer coverage, conducting manual benefit investigations when necessary.
- Identify and communicate patients' plan benefit coverage, including any prior authorization, appeal, tier exception, or formulary exclusion requirements.
- Utilize electronic resources to obtain benefit coverage outcomes, and if needed, conduct outbound calls to payers and healthcare providers for follow-up.
- Support adherence services through the coordination of nurse follow-up, as applicable to the program.
- Identify and recommend peer support resources for patients to enhance their treatment experience.
- Coordinate the shipment of products through patient assistance programs and/or bridge programs from the PharmaCord pharmacy.
- Proactively communicate the need for re-verification of prior authorization or re-enrollment for patient assistance programs.
- Report adverse events, product complaints, special situation reports, and medical inquiries in accordance with established SOPs and Business Rules.
- Document all activities within the PharmaCord Lynk system to maintain accurate and up-to-date records, adhering to business requirements.
Qualifications:
- Bachelor's degree strongly preferred or equivalent experience required; completion of a high school diploma or GED is required
- Customer service and healthcare industry experience strongly preferred
- Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday required
- Bi-lingual in English and Spanish or Chinese/Mandarin is a plus
- Commitment to the mission of care coordination
- Passionate, trustworthy, and empathetic when working with patients.
- Good communication and interpersonal skills and ability to speak concisely to patients
- Flexible and adaptable in response to changing patient and healthcare providers’ needs
- Professional telephone etiquette
- Self-awareness of your own emotions and the potential impact on others
- Basic computer knowledge
- Ability to multitask effectively
- Ability to recognize emotions and their effects
- Sureness about self-worth and capabilities
- Manage disruptive impulses
- Maintain standards of honesty and integrity
- Takes responsibility for performance
- Adapts and handles change with flexibility
- Is innovative and open to new ideas
- Achievement driven; constantly striving to improve or to meet a standard of excellence
- Aligns with the goals of the group or organization
- Ready to take initiative and act on opportunities
- Be optimistic and pursue goals persistently despite obstacles and setbacks
- Be service oriented and anticipate, recognize and meet the needs of others, including patients and care partners
- Positive attitude!
Physical Demands & Work Environment:
- 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.
- Although very minimal, flexibility to travel as needed is preferred.
- This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We’re committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
- Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
- Additional health support, including telehealth and Employee Assistance Program (EAP) services
- Company match on Health Savings Account contributions
- Free Basic Life and AD&D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000
- Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
- 401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting
- Paid Time Off (PTO) and Sick Leave to support work-life balance
- Team members receive nine paid holidays plus two floating holidays
- Opportunities for advancement in a company that supports personal and professional growth
- A challenging, stimulating work environment that encourages new ideas
- Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
- A mission-driven, inclusive culture where your work makes a meaningful impact
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.
Our Commitment to Equal Opportunity
At Valeris, we don’t just accept difference – 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.
Important Notice
Due to an increase in hiring scams, please be aware that if you are selected to move forward in our hiring process, a member of our Talent Acquisition team will contact you directly using an official @valeris.com and/or @echo.newtonsoftware.com email address regarding next steps in our interview process.
Please Note:
- PharmaCord will never use Microsoft Teams to reach out to candidates for interview scheduling. However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an @valeris.com or @echo.newtonsoftware.com email address, or through our scheduling platform, Calendly.
- We will never request your bank account information at any stage of the hiring process.
- We will never send a check (electronic or physical) to purchase home office equipment.
If you receive any suspicious communication regarding employment with PharmaCord, please report it to our Talent Acquisition team immediately at careers@valeris.com
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