Patient Navigator

About the role

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions across the healthcare value chain. Founded by the merger of PharmaCord and Mercalis, Valeris revolutionizes the path from life sciences innovation to real-life impact, aiming to ensure every patient receives the care they need.

Responsibilities

• Build and maintain trusted relationships with patients through proactive communication and timely services.
• Ensure compliance with relevant healthcare laws and regulations during all interactions and relationship management.
• Demonstrate experience with pharmacy benefit products and immunology practices to understand patient needs and concerns.
• Conduct program welcome calls, engaging patients effectively and explaining available services and resources.
• Use motivational interviewing techniques to involve patients in their healthcare objectives.
• Handle post-Benefit Investigation calls, clearly explaining coverage options to enhance patient understanding.
• Address client inquiries according to business rules, providing accurate and helpful information.
• Communicate complex reimbursement and billing information clearly to ensure patients understand their coverage benefits and financial responsibilities.
• Handle inbound calls based on approved Frequently Asked Questions (FAQs).
• Provide excellent customer service in a fast-paced environment, de-escalating challenging situations professionally and appropriately.
• Triage patients to appropriate internal or external resources based on their needs.
• Properly document and record patient enrollment, adhering to established business rules.
• Provide comprehensive information and education about products, including treatment courses, insurance coverage, costs, financial assistance resources, and ongoing support.
• Empower and inspire patients to manage their therapy plans as prescribed by their healthcare providers.
• Leverage electronic tools to identify benefits and payer coverage, conducting manual investigations when necessary.
• Identify and communicate patients' plan benefit coverage, including prior authorization, appeals, tier exceptions, and formulary exclusions.
• Support adherence services through nurse follow-ups, as applicable.
• Coordinate shipment of products through patient assistance programs and 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, and other 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.

Qualifications

• Bachelor's degree strongly preferred or equivalent experience required.
• High school diploma or GED required.
• Customer service and healthcare industry experience 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, able to speak concisely to patients.
• Flexible and adaptable in response to changing patient and healthcare providers’ needs.
• Professional telephone etiquette.
• Basic computer knowledge.
• Ability to multitask effectively.
• Recognition of emotions and their effects.
• Self-awareness of emotions and their impact on others.
• Manage disruptive impulses.
• Maintain standards of honesty and integrity.
• Take responsibility for performance.
• Adapt and handle change with flexibility.
• Be innovative and open to new ideas.
• Achievement driven; constantly strive to improve or meet a standard of excellence.
• Align with the goals of the group or organization.
• Ready to take initiative and act on opportunities.
• Pursue goals persistently despite obstacles and setbacks.
• Be service-oriented and anticipate, recognize, and meet the needs of others, including patients and care partners.
• Have a positive attitude!
• Physical demands and work environment: Regularly required to talk or hear, sit for long periods, 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. Minimal travel may be required.

Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premiums.
• Additional health support, including telehealth and Employee Assistance Program (EAP) services.
• Company match on Health Savings Account contributions.
• 401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting.
• Short-Term Disability coverage, with the option to purchase Long-Term Disability.
• Paid Time Off (PTO) and Sick Leave.
• Nine paid holidays plus two floating holidays.
• Opportunities for advancement in a supportive and inclusive culture.
• A challenging, stimulating work environment that encourages new ideas.
• A mission-driven, inclusive culture where your work makes a meaningful impact.

Prior to Employment

• Background check and, depending on the position, a drug screen required.
• Microsoft Teams used for interview scheduling is a scam.
• No checks for bank account information or purchase of home office equipment.
• Report any suspicious communications to the Talent Acquisition team at careers@valeris.com.