Care Coordinator
About this role
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, 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 www.valeris.com.
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:
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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
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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
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Inbound Call Management
Manages inbound calls as directed by the program-approved FAQs
Triage patients to internal or external resources as appropriate
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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 PharmaCord pharmacy
Proactively communicates needs for reverification of prior authorization or re-enrollment for patient assistance program
Reports adverse events, Product complaints, special situation reports and/or medical inquiries received in accordance with SOPs and the Business Rules
Documents all activities within the PharmaCord Lynk system in accordance with business requirements
Utilize Valeris’ values as the driving force behind the team’s success
On time adherence to training deadlines for all corporate policies and procedures
Ensure all SOPs are followed with consistency
Perform additional tasks or projects as assigned
Qualifications:
Successful candidates possess the following personal attributes:
Detail oriented
Professional telephone etiquette
Self-awareness of your own emotions and the potential impact on others
Basic computer knowledge
Ability to multitask effectively
Ability to recognize emotions and their effects
Sureness about self-worth and capabilities
Manage disruptive impulses
Maintain standards of honesty and integrity
Takes responsibility for performance
Adapts and handles change with flexibility
Is innovative and open to new ideas
Achievement driven; constant striving to improve or to meet a standard of excellence
Aligns with the goals of the group or organization
Ready to take initiative and act on opportunities
Be optimistic and pursue goals persistently despite obstacles and setbacks
Be service oriented and anticipate, recognize and meet needs of others, including patients and care partners
Clear and concise communication
Positive attitude!
Bachelor’s degree strongly preferred or equivalent experience required
Customer service and healthcare industry experience is preferred but not required
Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday required
Bi-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 need
Physical 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 costs
Additional health support, including telehealth and Employee Assistance Program (EAP) services
Company match on Health Savings Account contributions
Free Basic Life and AD&D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000
Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting
Paid Time Off (PTO) and Sick Leave to support work-life balance
Team members receive nine paid holidays plus two floating holidays
Opportunities for advancement in a company that supports personal and professional growth
A challenging, stimulating work environment that encourages new ideas
Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
A mission-driven, inclusive culture where your work makes a meaningful impact
Any 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 Opportunity
At 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.
Originally posted on Himalayas