Sr. Patient Navigator

Valeris•Morrisville, NC

92d•Onsite

About The Position

The Sr. Patient Navigator helps patients access life-altering medications by guiding them through complex processes such as insurance verification, prior authorizations, and appeals. The role provides personalized case management, compassionate customer service, relationship management, and reimbursement expertise while ensuring compliance with healthcare regulations. It also educates patients and healthcare providers on access, coverage, and reimbursement support. Roles are regionally aligned to support patients, and candidates must live within 30 miles of either the Morrisville, North Carolina, or Jeffersonville, Indiana headquarters. Travel to the closest headquarters will be required a few times per quarter at client request. Available shifts are 9:00 a.m.–6:00 p.m., 10:00 a.m.–7:00 p.m., and 11:00 a.m.–8:00 p.m. The position operates in a professional office environment and uses standard office equipment. The employee is regularly required to talk or hear, frequently sit for long periods, type, handle or feel objects, and reach with hands and arms. Candidates who can type at least 35 words per minute with 97% accuracy are preferred. Valeris is a life sciences commercialization partner formed by the merger of PharmaCord and Mercalis. It works with life sciences companies to improve patient access and adherence to critical medications, providing commercialization solutions to more than 500 customers and access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina, and Jeffersonville, Indiana.

Requirements

Bachelor's degree required; preferably in healthcare administration, social science, or a related field.
In lieu of a degree, 5–10 years of relevant experience in insurance reimbursement, patient access, direct patient care, or patient education may qualify.
Alternatively, relevant certifications such as PACS, CHES, or CCM, plus at least 5 consecutive years of related experience, may qualify in lieu of a degree.
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.
Must live within 30 miles of Valeris headquarters in Morrisville, NC, or Jeffersonville, IN.
Flexibility to travel as needed; travel is required a few times per quarter per client request.
Ability to talk and hear; sit for long periods; use hands to type, handle, or feel; and reach with hands and arms.
Employment offer is contingent on successful completion of a background check and, depending on the position, a drug screen.

Nice To Haves

At least two years of experience in healthcare access delivery or management is strongly preferred.
Bilingual or multilingual ability is a plus.
Typing speed of at least 35 words per minute with 97% accuracy is preferred.
Flexibility to travel as needed is preferred.

Responsibilities

Serve as the single point of contact and provide personalized case management for patients, caregivers, and healthcare providers, including benefit investigations, prior authorization tracking, and appeal support.
Educate patients, healthcare providers, and stakeholders on access and reimbursement processes, payer policies, and Valeris programs, including patient assistance and copay programs.
Build and maintain trusted relationships with patients, prescribers, and client stakeholders by providing accurate, timely, and compassionate support.
Coordinate and collaborate with client field teams according to agreed business rules and guidelines.
Communicate benefit coverage options and next steps in the patient journey using clear, patient-friendly language.
Use electronic tools to complete benefit investigations and help secure payer coverage for prescribed treatments.
Ensure activities comply with healthcare laws, regulations, and Valeris standard operating procedures, including HIPAA and insurance guidelines.
Identify and escalate adverse events, product complaints, and special situation reports as required by the program.
Document activities in the Valeris system and maintain detailed, accurate records.
Support adherence services, including patient education and coordination of nurse teaching when applicable.
Participate in team meetings and ongoing training to stay current on policies and procedures.
Travel to a designated nearby headquarters a few times per quarter when requested by a client.
Apply Valeris values to support team success.
Complete training deadlines for corporate policies and procedures on time.
Follow all SOPs consistently.
Perform additional tasks or projects as assigned.

Benefits

Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs.
Telehealth and Employee Assistance Program (EAP) services.
Company match on Health Savings Account contributions.
Free Basic Life and AD&D coverage equal to annual earnings, with a minimum of $50,000 and 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% contributed and immediate vesting.
Paid Time Off (PTO) and Sick Leave.
Nine paid holidays plus two floating holidays.
Opportunities for advancement and personal and professional growth.
A challenging, stimulating work environment that encourages new ideas.
Inclusive, mission-driven culture and deliberate efforts to create an inclusive workplace.