Executive Care Coordinator

About the role

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions spanning the entire healthcare value chain. The company was formed by the merger of PharmaCord and Mercalis, and it revolutionizes the path from life sciences innovation to real-life impact to build a world where every patient gets the care they need.

Responsibilities

• Builds trusted relationships with patients, prescribers, and appropriate client stakeholders regarding reimbursement inquiries and challenges through proactive communication, timely and accurate execution of deliverables, and demonstrating relentless passion for helping patients.
• Manages all relationships in a manner that adheres to all relevant laws, regulations, program-specific operating procedures, and industry standards related to access and affordability, including HIPAA and insurance guidelines.
• Supports inbound and outbound calls to patients, caregivers, specialty pharmacies, and healthcare professionals.
• Performs post-Benefit Investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey.
• Manages client inquiries as appropriate, such as case specific statuses.
• Manages HCP inquiries, as applicable, pursuant to business rules.
• Communicates with the client’s field teams in a manner that remains compliant and adheres to ways of working protocols outlined between Valeris and the client teams.

Qualifications

• Completion of Bachelor's degree (or higher) required. Degree in healthcare administration, social science, or similar related fields is strongly preferred.
• In lieu of a degree, five plus years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education is required.
• Minimum two years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education is required.
• Will consider other certifications and five or more consecutive years of experience in relevant field. Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist), or CCM in healthcare or social science (Certified Case Manager).
• Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
• Demonstrated examples of executing within guardrails recognizing urgency and consistently delivering patient centric results.
• Excellent attention to detail and organizational skills.
• Able to prioritize tasks and work efficiently in a fast-paced environment.
• Effective written and verbal communication and interpersonal skills, with the ability to interact professionally with diverse stakeholders.
• Demonstrates the ability to think critically and issue resolution.
• Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.

Skills

• Strong communication and interpersonal skills.
• Ability to manage multiple tasks and priorities.
• Understanding of medical and pharmaceutical terminology.
• Experience with insurance processes and reimbursement.
• Proficiency in electronic tools for identifying benefits and payer coverage.
• Excellent organizational and analytical skills.

Benefits

Valeris offers a comprehensive benefits package including medical, dental, and vision plans, with company contributions towards premiums. Additional health support includes telehealth and Employee Assistance Program (EAP) services. The company also provides a 401(k) retirement savings plan with a company match, free basic life and AD&D coverage, and paid time off (PTO) and sick leave.

Pay

Details on compensation are not specified in the job posting.

Schedule

The schedule is not specified in the job posting.