Executive Case Manager (Remote

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

The Executive Case Manager provides expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients. The Executive Case Manager responsibilities include education on the access and reimbursement support tools available from Pharma Cord and participating program, advising HCPs and/or patients and caregivers on the benefits and program eligibility for a specific patient, and educating HCP offices on Payor processes and procedures.

• Relationship Management
  • Builds trusted relationships with patients, prescribers, and appropriate client stakeholders regarding reimbursement inquiries and challenges 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 all relevant laws, regulations, program‑specific operating procedures and industry standards related to access and affordability, including HIPAA and insurance guidelines.
  • Managed through call/contact center structure, this role supports inbound and outbound calls to patients, caregivers, specialty pharmacies and healthcare professionals.
  • Performs post Benefits Investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey.
  • Manages all client inquiries and as appropriate, such as case specific statuses.
  • Manages HCP inquiries, as applicable, pursuant to business rules.
• All communications with the client’s field teams will remain compliant and adhere to ways of working protocols outlined between Pharma Cord and the client teams. 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, specialty pharmacies and patients to communicate benefit coverage and/or appropriately help drive next steps in obtaining coverage and/or access to prescribed medicine. All communications for case management will follow the guidelines set forth for the program and only provide information publicly available and/or outlined in the patient insert.
  • 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.
  • Serves as a subject matter expert to internal team as required and appropriate.
  • 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 nurse educators, as applicable to program
  • Supports adherence services as applicable to program.
  • Identifies peer support resources for patients.
  • Proactively communicates needs for reverification of prior authorization or…