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. We revolutionize the path from life sciences innovation to real-life impact, aiming to build a world where every patient gets the care they need. We work on behalf of life sciences companies to improve the patient experience, ensuring patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, and a talented team, Valeris offers data and strategic insights, patient support services, and healthcare provider engagement tools to help life sciences companies successfully commercialize new products.

Responsibilities

• Builds trusted relationships with patients, prescribers, and client stakeholders regarding reimbursement inquiries and challenges through proactive communication, timely and accurate execution of deliverables, and demonstrating a relentless passion for helping patients.
• Manages all relationships in compliance with 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, managing post-Benefit Investigation calls to explain coverage options and next steps.
• Performs personalized case management, providing communication to HCPs, specialty pharmacies, and patients to ensure benefit coverage and next steps in obtaining coverage and access to prescribed medicine.
• Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed, identifies and communicates patient’s plan benefit coverage, and follows up on proper submissions and outcomes with payers and HCPs.
• Serves as a subject matter expert to internal team as required and appropriate, coordinates nurse teach with nurse educators, supports adherence services, identifies peer support resources, proactively communicates needs for re-verification of prior authorization or re-enrollment, and identifies and reports adverse events, product complaints, special situation reports, and medical inquiries.
• Generates reports and analysis as needed to identify trends and opportunities for improvement, adhering to business requirements.
• Utilizes Valeris’ values as the driving force behind the team’s success, ensuring all SOPs are followed with consistency, and performs additional tasks or projects as assigned.

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. Two years of experience in these areas is required, with a minimum of two years of experience in healthcare access delivery or management strongly preferred. Will consider other certifications and five or more consecutive years of experience in relevant field, such as PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist), or CCM (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 resolve issues.
• Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.

Skills

• Strong communication and interpersonal skills.
• Ability to manage multiple tasks and prioritize effectively.
• Attention to detail and organizational skills.
• Understanding of medical terminology and coding systems.
• Experience in insurance reimbursement, patient access, and direct patient care.
• Knowledge of healthcare compliance regulations.

Benefits

At Valeris, we offer a comprehensive benefits package including medical, dental, and vision plans, with company contributions toward premiums. Additional health support includes telehealth and an Employee Assistance Program (EAP). We also provide free basic life and AD&D coverage, with a minimum of $50,000 and a maximum of $300,000. Company-paid short-term disability coverage is available, with the option to purchase long-term disability. Our 401(k) retirement savings plan offers a 100% match on the first 5% contributed, with immediate vesting. We also provide paid time off (PTO) and sick leave, as well as nine paid holidays plus two floating holidays. Opportunities for advancement are available, and we strive to create a challenging, stimulating work environment that encourages personal and professional growth. We are committed to supporting the well-being and success of our team members and making deliberate efforts to create an inclusive workplace. Valeris is proud to be an equal opportunity employer.

Pay

The starting salary range for this role is $60,000 - $80,000 annually, depending on experience and qualifications.

Schedule

The 11:30 AM - 8 PM ET shift is required for this role.