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Patient Navigator

Mercalis

Shifts for this role will be Monday–Friday, 10:00 AM–7:00 PM or 11:00 AM–8:00 PM EST only. Valeris is a life sciences commercialization partner that provides comprehensive solutions for life science companies. Responsibilities Serve as the single point of contact and provide personalized case management for patients, caregivers, and healthcare providers, including benefit investigations, prior authorization tracking, and appeal support. Educate patients, HCPs, and stakeholders on access and reimbursement processes, payer policies, and Valeris programs such as patient assistance and copay programs. Build and maintain trusted relationships with patients, prescribers, and client stakeholders by delivering accurate, timely, and compassionate support. Coordinate and collaborate with client field teams following agreed‑upon business rules and guidelines. Communicate benefit coverage options and next steps in the patient journey using clear and patient‑friendly language. Leverage electronic tools to navigate and complete benefit investigations, ensuring payer coverage is secured for prescribed treatments. Ensure all activities comply with healthcare laws, regulations, and Valeris standard operating procedures (e.g., HIPAA, insurance guidelines). Identify and report adverse events, product complaints, and special situation reports as required by the program. Document all activities in the Valeris system, maintaining detailed and accurate records. Support adherence services, including patient education and coordinating nurse teaching as applicable. Participate in team meetings and ongoing training to stay updated on policies and procedures. Apply Valeris’ values as the driving force behind the team’s success. Adhere to training deadlines for all corporate policies and procedures. Follow all SOPs consistently. Perform additional tasks or projects as assigned. Qualifications Completion of a bachelor’s degree (or higher) required. Degree in healthcare administration, social science, or similar related field strongly preferred. Minimum two years of experience in healthcare access delivery or management strongly preferred. Five to ten years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education considered in lieu of a degree. Additional certifications and five or more consecutive years of relevant experience may be considered (e.g., PACS, CHES, CCM). Strong understanding of medical terminology, coding systems (ICD‑10, CPT, HCPCS), and insurance processes. Ability to prioritize tasks and work efficiently in a fast‑paced environment. Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines. Bilingual or multilingual proficiency is a plus. Physical Demands & Work Environment Regularly required to talk or hear; frequently required to sit for long periods, use hands to type, handle or feel items, and reach with hands and arms. Preferred candidates can type at least 35 words per minute with 97% accuracy. Flexibility to travel as needed is preferred. Operates in a professional office environment using standard equipment such as computers, phones, and photocopiers. Benefits Medical, dental, and vision plans, including HSA‑ and FSA‑eligible options. Additional health support, including telehealth and Employee Assistance Program services. Company match on Health Savings Account contributions. Free basic life and AD&D coverage equal to your annual earnings (minimum $50,000, maximum $300,000). Company‑paid short‑term disability coverage, with option to purchase long‑term disability. 401(k) retirement savings plan with 100% match on the first 5% of employee contributions, with immediate vesting. Paid time off (PTO) and sick leave. Nine paid holidays plus two floating holidays. Opportunities for advancement and professional growth. Work environment that values diversity, inclusion, and creativity. Mission‑driven culture where your work makes a meaningful impact. Equal Opportunity Valeris is an equal‑opportunity employer. We celebrate difference, support diversity, and thrive on it for the benefit of our employees, products, and community. This description is not exhaustive; responsibilities and tasks may change without notice. #J-18808-Ljbffr

Vacancy posted more than 2 months ago

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