Care Coordinator

Valeris; Indiana (PA); On-site; USD 27,552 - 41,328; Full time

Job summary

Valeris is seeking a Care Coordinator to manage patient cases from initiation to closure, including benefit investigations and prior authorizations. The role uses the Lynk system to access payer coverage and coordinate with healthcare providers, ensuring accurate, timely support in a patient-focused environment.

The position requires ownership, attention to detail, and strong communication to navigate healthcare rules and ensure successful patient outcomes. Shift runs 11:30 AM to 8 PM ET.

Qualifications

• Attention to detail and accuracy in handling patient information.
• Professional telephone etiquette for patient and provider interactions.
• Ability to multitask and manage multiple cases concurrently.
• Ability to recognize emotions and their effects on stakeholders.
• Basic computer skills for data entry and case documentation.

Responsibilities

• Own patient cases from initiation to closure, including investigations and authorizations.
• Provide personalized case management and communicate benefit coverage and next steps.
• Coordinate with nurse educators and adhere to SOPs and business rules.
• Document all activities in the Lynk system and maintain compliance.

Skills

Detail oriented

Professional telephone etiquette

Multitasking

Emotional intelligence

Basic computer skills

Tools

Lynk system

Job description

About Valeris

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.

The 11:30 AM - 8 PM ET shift is required for this role.

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

• 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
• 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
• 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 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

• 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