Sr. Patient Navigator

Valeris, Inc.; North Carolina; Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health benefits

Telehealth & EAP

401(k) match

Paid time off

Holidays & leave

Career growth

Job summary

Valeris, Inc. is seeking a Sr. Patient Navigator to ensure patients gain access to life-changing medications through insurance verification, prior authorizations, and appeals.

You will educate providers and patients on access, coverage, and reimbursement programs, while managing cases and maintaining strong relationships. You will collaborate with client field teams, adhere to healthcare regulations, document activities thoroughly, and support adherence services.

Qualifications

• Bachelor's degree required, preferably in healthcare administration or related field.
• 5-10 years of experience in insurance reimbursement, patient access, direct patient care, or patient education, or relevant certifications with at least 5 consecutive years of related experience.
• Minimum two years of experience in healthcare access delivery or management is preferred.
• Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
• Knowledge of HIPAA and Medicare/Medicaid guidelines.
• Bilingual/multilingual is a plus.

Responsibilities

• Serve as the single point of contact providing personalized case management for patients, caregivers, and healthcare providers, including benefit investigations and prior authorization tracking.
• Educate patients, HCPs, and stakeholders on access, payer policies, and Valeris programs.
• Build and maintain trusted relationships with patients, prescribers, and client stakeholders with accurate, timely support.
• Coordinate with client field teams following agreed-upon business rules and guidelines.
• Communicate benefit coverage options and next steps in the patient journey in clear terms.
• Document all activities in the Valeris system with detailed records.
• Travel may be required per client request a few times per quarter.

Skills

Healthcare access

Medical terminology

HIPAA

Prioritization

Bilingual

Education

Bachelor's degree in healthcare administration

5-10 years relevant experience

Job description

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; 10AM-7PM; 11AM-8PM EST MON-FRIDAY

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 MAY 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.
• 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 routinely uses standard office equipment such as computers, phones, photocopiers, etc.

Why Work for Valeris?

• 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.

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.

A Name With Purpose. Inspired by those who work each day to transform access and enhance lives, our name emerges from the root valor: to be bold, brave, determined, be well, have worth. It speaks to integrity, simplicity, strength, and principled action. Valeris merges this with vision and an intention to redefine value at every step in the patient journey. We honor the science. We unlock the value. We do it with vision. We are Valeris.

Purpose: Valeris represents measurable business impact through healthcare innovation that transforms lives. We combine cutting-edge technology with healthcare expertise to tackle challenges in access, affordability, and quality of care. Success means improving patient outcomes - everything we do is anchored in the value of improving human lives.