Sr. Patient Navigator

Valeris

Morrisville (NC)

Sur place

USD 70 000 - 90 000

Plein temps

14 jours+

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Avantages offerts par ce poste

Medical benefits

Dental benefits

Vision benefits

HSA/FSA options

401(k) match

Paid time off

Holidays

Résumé du poste

Valeris is hiring a Sr. Patient Navigator to guide patients through insurance verification, prior authorizations, and appeals. You will educate on access and reimbursement, build relationships with patients, prescribers, and client stakeholders, and ensure payer coverage for prescribed therapies.

Travel to HQs in Morrisville, NC or Jeffersonville, IN will be required a few times per quarter. The role demands strong knowledge of ICD-10/CPT/HCPCS, 5+ years in healthcare access, and a bachelor’s

Qualifications

Bachelor's degree required; healthcare admin or related field preferred.
5–10 years in insurance reimbursement, patient access, direct patient care, or education.
Certifications (PACS, CHES, CCM) plus 5+ years of related experience preferred.
Minimum 2 years in healthcare access delivery or management preferred.

Responsabilités

Serve as single point of contact delivering case management for patients, caregivers, and HCPs.
Educate on access, reimbursement processes, payer policies, and Valeris programs.
Build trusted relationships with patients and prescribers delivering accurate support.
Coordinate with client field teams following agreed rules and guidelines.
Communicate coverage options clearly and guide patients through next steps.
Navigate benefit investigations and ensure payer coverage for prescribed treatments.
Ensure compliance with HIPAA, Medicare/Medicaid, and Valeris SOPs.
Identify adverse events and document activities in Valeris system.
Support patient education and nurse teaching as applicable.
Attend team meetings and training to stay updated on policies.

Connaissances

Insurance reimbursement

Patient access

Healthcare terminology

HIPAA compliance

Bilingual (plus)

Formation

Bachelor's degree in healthcare administration or related field

Outils

ICD-10, CPT, HCPCS

Description du poste

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.

Shifts Available: 9AM - 6PM (9); 10AM - 7PM (4), 11AM - 8PM (3)

The Sr. Patient Navigator plays a critical role in ensuring patients have access to life-altering medications by supporting them through complex processes such as insurance verification, prior authorizations, and appeals. This position combines exceptional customer service, relationship management, and expertise in reimbursement practices to provide personalized support and ensure compliance with all healthcare regulations. The role also focuses on educating healthcare providers and patients on access, coverage, and reimbursement support. These roles will be regionally aligned to best support patients.

Key Responsibilities:

Serves as the single point of contact and provides personalized case management for patients, caregivers, and healthcare providers (HCPs), including delivery of benefit investigations, prior authorization tracking, and appeal support.
Educate patients, HCPs, and stakeholders on access and reimbursement processes, payer policies, and Valeris programs (e.g., patient assistance programs, 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 elevate 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.
Travel WILL BE required per client request a few times per quarter. Travel will be designated to the HQ closest to the selected candidate(s) in either Morrisville, NC or Jeffersonville, IN - therefore desired candidate(s) must live within 30 miles of either HQ.
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:

Bachelor’s degree required, preferably in healthcare administration, social science, or a related field.
- In lieu of a degree, candidates may qualify with:
5-10 years of relevant experience in areas such as insurance reimbursement, patient access, direct patient care, or patient education, or
Relevant certifications (e.g., PACS, CHES, or CCM) plus at least 5 consecutive years of related experience.
Minimum two (2) years of experience in healthcare access delivery or management is strongly preferred.
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 / Multilingual is a plus.

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 routine 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.

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 routine 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