Executive Care Coordinator

🔥 4 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Executive

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Valeris

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💊 Pharmaceuticals

🏥 Healthcare

🤝 B2B

Pharmaceuticals • Healthcare • B2B

Valeris is a fully integrated life sciences commercialization partner formed by the merger of PharmaCord and Mercalis. The company provides comprehensive solutions across the healthcare value chain to help life sciences companies bring products to market and improve patient access and adherence. Valeris offers data and strategic insights, patient support and access programs, and healthcare provider engagement tools, serving over 500 life sciences customers and supporting millions of patients. Headquartered in Morrisville, North Carolina and Jeffersonville, Indiana, Valeris focuses on enabling commercialization and patient-centric services for pharmaceutical and life sciences organizations.

📋 Description

• 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 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 PharmaCord 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. • 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 re-enrollment. • Identifies and reports adverse events, product complaints, special situation reports and/or medical inquiries received in accordance with program operating procedures and the Business Rules. • Documents all activities within the Lynk system, maintaining detailed records of reimbursement activities, including claims status, payments, and appeals. • Generate reports and analysis as needed to identify trends and opportunities for improvement. 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

🎯 Requirements

• Completion of Bachelor's degree (or higher) required • A degree in healthcare administration, social science or similar related fields is strongly preferred. • Minimum two years of experience in healthcare access delivery or management is strongly preferred. • 5-10 years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education experience will be considered in lieu of degree. • Will consider other certifications and five or more consecutive years of experience in relevant field. • Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist) or CCM in healthcare or social science (Certified Case Manager). • Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes. • Excellent attention to detail and organizational skills. • Ability to prioritize tasks and work efficiently in a fast-paced environment. • Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines. • Bi-lingual skills are a plus.

🏖️ Benefits

• 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