Case Manager / Patient Advocate (non-clinical)
VALERIS
Location: Jeffersonville, IN Remote Status: Remote Job Id: 804 # of Openings: 0 Overview Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Valeris™ focuses on improving the patient experience to help patients access and adhere to critical medications. The company provides data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris serves 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. For more information, visit Responsibilities A typical day in the Case Manager / Patient Advocate (non-clinical) role includes ownership of patient cases from initiation to closure, including 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 Lynk technology) by applying critical thinking and knowledge of program rules and standards. This role requires a high level of ownership, meticulous attention to detail and patient focus. Key Responsibilities Relationship Management Build trusted relationships with patients, prescribers and client stakeholders through proactive communication, timely and accurate execution of deliverables, and a patient-first mindset Manage relationships in compliance with healthcare laws and regulations Communications Perform program welcome calls to patients Explain coverage options during post Benefits Investigation calls to patients and physicians Respond to client inquiries not readily answered by the client through reporting Handle healthcare professional inquiries in accordance with business rules Inbound Call Management Manage inbound calls per program-approved FAQs Triage patients to internal or external resources as appropriate Personalized Case Management Provide personalized case management to patients and healthcare professionals, communicating benefit coverage and next steps Use electronic tools to identify benefits and payer coverage; complete manual benefit investigations as needed Identify and communicate patient plan benefit coverage, including need for prior authorization, appeals, tier exceptions, and formulary exclusions Use electronic resources to obtain coverage outcomes and follow up with payers and HCPs as needed Coordinate nurse teaching with field-based nurse educators as applicable Support adherence services through nurse follow-up as applicable Identify peer support resources for patients Coordinate shipment of product through patient assistance and bridge programs Proactively communicate needs for reverification of prior authorization or re-enrollment Report adverse events, product complaints, special situation reports and medical inquiries per SOPs and business rules Document all activities in the PharmaCord Lynk system per business requirements Demonstrate Valeris values in daily work Adhere to training deadlines for corporate policies and procedures Follow SOPs consistently and perform additional tasks or projects as assigned Qualifications Successful candidates possess the following personal attributes: Detail oriented Self-awareness of emotions and their impact on others Basic computer knowledge Ability to multitask effectively Ability to recognize emotions and their effects Self-confidence in abilities Honesty and integrity Takes responsibility for performance Adaptable and flexible Innovative and open to new ideas A chievement driven; strives for excellence Aligned with group or organizational goals Proactive and initiative-taking Optimistic and persistent Service oriented, meeting needs of patients and care partners Clear and concise communication Bachelor’s degree strongly preferred or equivalent experience Customer service and healthcare industry experience preferred but not required Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday Bi-lingual skills in Spanish and English are a plus Remote work eligibility based on business need and work-from-home criteria Physical Demands & Work Environment Regularly required to talk or hear; frequently sit for long periods, type, and reach with hands and arms; typing speed of at least 35 words per minute with 97% accuracy preferred Minimal travel may be required Professional office environment with standard office equipment Why Work for Valeris We’re committed to supporting the well-being and success of our team members. Full-time employees can expect: Medical, dental and vision plans with options and company contribution toward premiums Additional health support, including telehealth and EAP services Company match on Health Savings Account contributions Life and AD&D coverage Short-Term Disability coverage (Long-Term Disability available) 401(k) with company match and immediate vesting PTO and Sick Leave Opportunities for advancement and professional growth Inclusive, diverse, and mission-driven culture Any offer of employment is contingent upon a background check and, depending on the position, a drug screen. This job description is not exhaustive and responsibilities may change at any time. Our Commitment to Equal Opportunity Valeris is an equal opportunity employer and values diversity. We celebrate differences and are committed to creating an inclusive workplace. Note: For security, you may be contacted by our Talent Acquisition team from official Valeris or echo.newtonsoftware email addresses. Do not share bank information or send payments to purchase equipment during the process. Please Note PharmaCord will never use Microsoft Teams to reach out for interview scheduling, though video interviews may occur via Teams. Official meeting links will come from official Valeris or echo.newtonsoftware email addresses, or Calendly. We will never request bank account information during the hiring process. We will never send checks to purchase home office equipment. If you have concerns about suspicious communications, contact us at View email address on click.appcast.io. #J-18808-Ljbffr VALERIS
$83k - $89k
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