Case Manager / Patient Advocate (non-clinical)
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, ValerisTM revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.A typical day in the Case Manager / Patient Advocate (non-clinical) role will include ownership of your patients cases from initiation to closure to include; benefit investigations, prior authorizations / denial appeals, determining financial qualifications for assistance programs and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, Lynk) by using your critical thinking skills and your knowledge of the program and industry rules and standards. This role requires a high level of ownership, attention to detail and patient focus and will put your problem-solving skills to the test!Key Responsibilities:The responsibilities include, but are not limited to the following:Relationship Management Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patientsManages all relationships in a manner that adheres to healthcare laws and regulationsCommunications Performs program welcome calls to patientsPerforms post Benefits Investigation calls to patients and physicians explaining coverage optionsManages all client inquiries unable to be determined by client through reportingManages HCP inquiries, as applicable, pursuant to business rulesInbound Call Management Manages inbound calls as directed by the program-approved FAQsTriage patients to internal or external resources as appropriatePersonalized Case Management Provides personalized case management to patients and HCPs including outbound communication to HCPs and patients to communicate benefit coverage and next steps in obtaining coverageLeverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as neededIdentifies and communicates patient's plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusionsUses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcomeCoordinates nurse teach with field-based nurse educators, as applicable to programSupports adherence services through coordination of nurse follow up, as applicable to programIdentifies peer support resources for patientsCoordinates shipment of product through patient assistance program and/or bridge program from the PharmaCord pharmacyProactively communicates needs for reverification of prior authorization or re-enrollment for patient assistance programReports adverse events, Product complaints, special situation reports and/or medical inquiries received in accordance with SOPs and the Business RulesDocuments all activities within the PharmaCord Lynk system in accordance with business requirementsUtilize Valeris' values as the driving force behind the team's successOn time adherence to training deadlines for all corporate policies and proceduresEnsure all SOPs are followed with consistencyPerform additional tasks or projects as assignedQualifications:Successful candidates possess the following personal attributes: Detail orientedProfessional telephone etiquetteSelf-awareness of your own emotions and the potential impact on othersBasic computer knowledgeAbility to multitask effectivelyAbility to recognize emotions and their effectsSureness about self-worth and capabilitiesManage disruptive impulsesMaintain standards of honesty and integrityTakes responsibility for performanceAdapts and handles change with flexibilityIs innovative and open to new ideasAchievement driven; constant striving to improve or to meet a standard of excellenceAligns with the goals of the group or organizationReady to take initiative and act on opportunitiesBe optimistic and pursue goals persistently despite obstacles and setbacksBe service oriented and anticipate, recognize and meet needs of others, including patients and care partnersClear and concise communicationPositive attitude!Bachelor's degree strongly preferred or equivalent experience requiredCustomer service and healthcare industry experience is preferred but not requiredAbility to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday requiredBi-lingual skills in Spanish and English are a plus.Remote work eligibility is subject to all work from home criteria met and based on business needPhysical Demands & Work Environment: While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, 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.Although very minimal, flexibility to travel as needed is preferred.This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.Why Work for Valeris:We're 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 costsAdditional health support, including telehealth and Employee Assistance Program (EAP) servicesCompany match on Health Savings Account contributionsFree Basic Life and AD&D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vestingPaid Time Off (PTO) and Sick Leave to support work-life balanceTeam members receive nine paid holidays plus two floating holidaysOpportunities for advancement in a company that supports personal and professional growthA challenging, stimulating work environment that encourages new ideasWork for a company that values diversity and makes deliberate efforts to create an inclusive workplaceA mission-driven, inclusive culture where your work makes a meaningful impactAny offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.Our Commitment to Equal OpportunityAt Valeris, we don't just accept difference - we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.Important NoticeDue to an increase in hiring scams, please be aware that if you are selected to move forward in our hiring process, a member of our Talent Acquisition team will contact you directly using an official @Valeris.com and/or @echo.newtonsoftware.com email address regarding next steps in our interview process.Please Note: PharmaCord will never use Microsoft Teams to reach out to candidates for interview scheduling. However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an @Valeris.com or @echo.newtonsoftware.com email address, or through our scheduling platform, Calendly .We will never request your bank account information at any stage of the hiring process.We will never send a check (electronic or physical) to purchase home office equipment.If you receive any suspicious communication regarding employment with PharmaCord, please report it to our Talent Acquisition team immediately at careers@Valeris.com#INDCMPA