Existing Program! Specialty Pharmacy Account Liaison

About the role

The Existing Program! Specialty Pharmacy Account Liaison role at Valeris involves delivering exceptional patient experiences while managing relationships with specialty pharmacies, patients, prescribers, and client stakeholders. The position requires adherence to healthcare laws and regulations, effective communication, and the ability to manage various client inquiries.

Responsibilities

• Builds trusted relationships with specialty pharmacies, patients, prescribers, and client stakeholders through proactive communication, timely and accurate execution of deliverables, and demonstrating a relentless passion for helping patients.
• Manages all relationships in compliance with healthcare laws and regulations.
• Performs post-Benefits Investigation calls to payors, patients, or physicians to verify or explain coverage options.
• Manages all client inquiries that cannot be resolved by the client through reporting.
• Manages Healthcare Provider (HCP) inquiries, as applicable, according to business rules.
• Manages direct inbound calls from specialty pharmacy contacts, triaging patients to internal or external resources as necessary.
• Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigations as needed.
• Identifies and communicates patient's plan benefit coverage, including the need for prior authorization, appeals, tier exceptions, and/or formulary exclusions.
• Coordinates nurse education teach sessions with field-based nurse educators, as applicable to the program.
• Supports adherence services through coordination of nurse follow-up, as applicable to the program.
• Identifies peer support resources for patients and tracks and follows up on the shipment of product through patient assistance programs and/or bridge programs from the PharmaCord pharmacy.
• Proactively communicates needs for re-verifications of prior authorizations or re-enrollments for patient assistance programs.
• Reports adverse events, product complaints, special situation reports, and/or medical inquiries in accordance with Standard Operating Procedures (SOPs) and business rules.
• Documents all activities within the Lynk system in accordance with business requirements.
• Utilizes Valeris' values as the driving force behind the team's success.
• Ensures adherence to training deadlines for all corporate policies and procedures.
• Follows all SOPs with consistency.
• Performs additional tasks or projects as assigned.

Qualifications

• Successful candidates must possess detailed orientation, professional telephone etiquette, self-awareness of emotions, basic computer knowledge, multitasking abilities, ability to recognize emotions, sureness about self-worth and capabilities, management of disruptive impulses, maintenance of standards of honesty and integrity, taking responsibility for performance, adaptability to change, innovation, achievement-driven mindset, alignment with group or organizational goals, readiness to take initiative, pursuit of goals despite obstacles and setbacks, service orientation, anticipation and recognition of needs of others, including patients and care partners, clear and concise communication, positive attitude, and ideally, experience working with specialty pharmacies.
• A Bachelor’s degree in arts and sciences, social work, public health administration, or a related field is preferred; a high school diploma or GED is required.
• Three years of customer service, payer benefits (reimbursement, prior authorization, etc.), and healthcare industry experience is preferred.
• Ability to work any 8.5-hour shift between 8 am to 8 pm, Monday to Friday, with flexibility to travel as needed.
• Bi-lingual in English and Spanish or Chinese/Mandarin is a plus.

Physical Demands & Work Environment

This job operates in a professional office environment. The employee is regularly required to talk or hear, sit for long periods, use hands to type, handle, or feel, and reach with hands and arms. Flexibility to travel as needed is preferred. The employee is required to type at least 35 words per minute with 97% accuracy.

Why Work for Valeris

At Valeris, we support the well-being and success of our team members. 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 includes telehealth and Employee Assistance Program (EAP) services. We offer a 401(k) Retirement Savings Plan with a 100% match on the first 5% you contribute, with immediate vesting. Paid Time Off (PTO) and Sick Leave are provided to support work-life balance. Team members receive nine paid holidays plus two floating holidays, opportunities for advancement, and a challenging, stimulating work environment that encourages new ideas. We strive to create a diverse and inclusive workplace where your work makes a meaningful impact.

Equal Opportunity Employer

We are 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 includes telehealth and Employee Assistance Program (EAP) services. We offer a 401(k) Retirement Savings Plan with a 100% match on the first 5% you contribute, with immediate vesting. Paid Time Off (PTO) and Sick Leave are provided to support work-life balance. Team members receive nine paid holidays plus two floating holidays, opportunities for advancement, and a challenging, stimulating work environment that encourages new ideas. We strive to create a diverse and inclusive workplace where your work makes a meaningful impact.