Patient Navigator

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Act as the primary point of contact, delivering tailored case management for patients, caregivers, and healthcare professionals.

• Conduct benefit investigations, track prior authorizations, and provide support for appeals.

• Educate patients, healthcare providers, and stakeholders about access and reimbursement procedures, payer policies, and Valeris programs.

• Establish and nurture trusted relationships with patients, prescribers, and client stakeholders.

• Collaborate and coordinate with client field teams in accordance with business rules and guidelines.

• Communicate benefit coverage options and next steps using patient-friendly terminology.

• Utilize electronic tools to conduct benefit investigations and obtain payer coverage for prescribed therapies.

• Ensure adherence to healthcare laws, regulations, HIPAA, insurance guidelines, and Valeris standard operating procedures.

• Identify and report adverse events, product complaints, and special situation reports.

• Accurately document activities within the Valeris system.

• Assist with adherence services, which include patient education and nurse-teaching coordination.

• Engage in team meetings and continuous training.

• Occasional travel may be required a few times per quarter to the nearest headquarters in Morrisville, NC or Jeffersonville, IN, per client request.

• Meet training deadlines and consistently follow standard operating procedures.

• Carry out additional assigned tasks and projects.

⛳️ Requirements

• A bachelor's degree is required, ideally in healthcare administration, social science, or a related discipline.

• Alternatively, 5–10 years of relevant experience in insurance reimbursement, patient access, direct patient care, or patient education may substitute for a degree.

• Equivalent certifications such as PACS, CHES, or CCM along with a minimum of 5 consecutive years of related experience will also be considered.

• At least two years of experience in healthcare access delivery or management is strongly preferred.

• A solid understanding of medical terminology and coding systems, including ICD-10, CPT, and HCPCS, is essential.

• Familiarity with insurance processes is required.

• Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines, is necessary.

• Ability to prioritize tasks and operate efficiently in a fast-paced environment is essential.

• Bilingual or multilingual abilities are a plus.

• Proficiency in typing at least 35 words per minute with 97% accuracy is preferred.

• Willingness to travel as needed is preferred.

• Successful completion of a background check and, depending on the role, a drug screening is required.

🏝️ Benefits

• Medical, dental, and vision insurance plans, including options eligible for HSA and FSA, with Valeris contributing toward premium costs.

• Access to Telehealth and Employee Assistance Program (EAP) services.

• Company contributions on Health Savings Account deposits.

• Complimentary Basic Life and AD&D coverage equivalent to annual earnings, with a minimum of $50,000 and a maximum of $300,000.

• Company-funded Short-Term Disability coverage, with the option to purchase Long-Term Disability.

• 401(k) Retirement Savings Plan featuring a 100% match on the first 5% contributed, with immediate vesting.

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for career advancement and both personal and professional development.

• A challenging and stimulating work environment that fosters new ideas.

• An inclusive workplace with a mission-driven culture.

• Background checks and, depending on the position, drug screenings are contingent upon an employment offer.