Bilingual Case Manager (English/Spanish)

About the role

The Bilingual Case Manager (English/Spanish) plays a crucial role in improving the patient experience by providing comprehensive support to patients and healthcare providers. This role involves managing patient cases from initiation to closure, handling benefit investigations, prior authorizations, and appeals, and ensuring timely and accurate communication.

Responsibilities

• Builds trusted relationships with patients, prescribers, and client stakeholders through proactive communication and timely execution of deliverables.
• Adheres to healthcare laws and regulations when managing all relationships.
• Performs program welcome calls to patients and explains coverage options following benefits investigations.
• Triage client inquiries and manages HCP inquiries according to business rules.
• Manages inbound calls, triaging patients to internal or external resources as necessary.
• Provides personalized case management to patients and HCPs, including outbound communication and follow-up calls.
• Leverages electronic tools to identify benefits and payer coverage, completing manual investigations as needed.
• Communicates patient's plan benefit coverage, including the need for prior authorization, appeal, tier exceptions, and formulary exclusions.
• Coordinates nurse education and patient assistance program shipments.
• Supports adherence services through nurse follow-up and reports adverse events and medical inquiries.
• Identifies and coordinates peer support resources for patients.
• Utilizes Valeris' values to drive team success and ensures compliance with all SOPs and training deadlines.

Qualifications

• Bachelor’s degree strongly preferred.
• Fluency in Spanish and English is required.
• Customer service and healthcare industry experience is preferred but not required.
• Able to work an 8.5-hour shift between 8 am to 11 pm, Monday to Friday.
• Bi-lingual in English and Spanish or Chinese/Mandarin is a plus.
• This is an office-based position requiring extended sitting and occasional travel.

Benefits & Perks

• Medical, dental, and vision plans with HSA- and FSA-eligible options, with Valeris contributing to premiums.
• Telehealth and Employee Assistance Program (EAP) services.
• Company match on Health Savings Account contributions.
• Short-Term and Long-Term Disability coverage.
• 401(k) Retirement Savings Plan with a 100% match on the first 5% contributed, with immediate vesting.
• Paid Time Off (PTO) and Sick Leave.
• Nine paid holidays plus two floating holidays.
• Opportunities for advancement in a supportive, diverse, and mission-driven culture.

Schedule

This role may be eligible for a hybrid schedule after 6 months (or sooner based on proficiency).

Physical Demands & Work Environment

Regularly sits for long periods and uses hands for typing, handling, and feeling. Must be able to type at least 35 words per minute with 97% accuracy.

Why Work for Valeris?

Valeris offers a range of benefits including medical, dental, and vision plans, health support, and retirement savings plans. The company also provides opportunities for advancement and a supportive, diverse culture.