Care Coordinator

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 Pharma Cord and Mercalis, Valeris 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  8:30 AM - 5 PM ET shift is required for this role.

A typical day in the Care Coordinator 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 patients

Manages all relationships in a manner that adheres to healthcare laws and regulations

Communications

Performs program welcome calls to patients

Performs post Benefits Investigation calls to patients and physicians explaining coverage options

Manages all client inquiries unable to be determined by client through reporting

Manages HCP inquiries, as applicable, pursuant to business rules

Inbound Call Management Manages inbound calls as directed by the program-approved FAQs Triage patients to internal or external resources as appropriate

Personalized 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 coverage

Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed

Identifies and communicates patient’s plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions

Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome

Coordinates nurse teach with field-based nurse educators, as applicable to program

Supports adherence services through coordination of nurse follow up, as applicable to program

Identifies peer support resources for patients

Coordinates shipment of product through patient assistance program and/or bridge program from the Pharma Cord pharmacy

Proactively communicates needs for reverification of prior authorization or re-enrollment for patient…